School Bus Registration Form for Current School Year

District

School

Grade

Student Last Name

Student First Name

Gender

Birth Date

Student ID Any number can be used in the field, it cannot be left blank.

Program

Section A: Student Information

Use the following examples to help complete the address fields:

Right	Wrong
RGE RD	Range Road; RR
TWP RD	Township Road
HWY	Highway
ST	Street, St.(NO PERIOD)
AVE	Avenue, AVE.
101 ST	101^st ST
2 AVE	2^ND AVE
689 HWY	Highway 689

Parent/Guardian

Last Name

First Name

Home Phone

Work Phone

Cell Phone

Physical or Residential Address (where the student resides)

Number

Street

City

Postal Code

Apartment

Mailing Address (if different from above)

Parent/Guardian 2

Last Name

First Name

Home Phone

Work Phone

Cell Phone

Physical or Residential Address (where the student resides)

Number

Street

City

Postal Code

Apartment

Mailing Address (if different from above)

Are either parents of this student of the Catholic Faith?

Transportation may be provided to and/or from home/sitter/joint custody location, if the arrangement is permanent (5 days per week) and this location can be safely scheduled into the regular routes and is within the pupil's home school attendance boundary.

This student requires transportation for the following (check all that apply)

Home Address

Sitter Address

Joint Custody Address

Joint Custody Sitter Address

Alternate/Interschool Address

Is transportation for sibling required?

Section C: Alternate Address Information

Sitter

Last Name

First Name

Home Phone

Work Phone

Cell Phone

Alternate Address (where the student needs to go, other than home)

Number

Street

City

Postal Code

Apartment

Joint Custody

Last Name

First Name

Home Phone

Work Phone

Cell Phone

Alternate Address (where the student needs to go, other than home)

Number

Street

City

Postal Code

Apartment

Joint Custody Sitter

Last Name

First Name

Home Phone

Work Phone

Cell Phone

Alternate Address (where the student needs to go, other than home)

Number

Street

City

Postal Code

Apartment

Alternate/Interschool

Last Name

First Name

Home Phone

Work Phone

Cell Phone

Alternate Address (where the student needs to go, other than home)

Number

Street

City

Postal Code

Apartment

Interschool

AM School 1

AM School 2

PM School 1

PM School 2

Section D: Out of School Attendance Boundary Only complete this section if the addresses entered above are outside of the boundary for the requested School

Section E: Medical Information

Special needs or medical conditions the driver should be aware of

Section F: Guardian at Stop Contract

Acknowledgment

PRSD Responsibility

PRSD shall provide safe and reliable transportation for students while being transported to and from school. We recognize the vital role parents play in the safe transportation of students, and have developed operating procedures to identify the responsibilities for communication and co-operation between the parents/guardians, school, and transportation services.

Parent Responsibilities

a) Parents/guardians with the help of school staff and/or the bus driver may arrange "bus buddies" for students who require them
b) It is recommended that Parents/Guardians or a responsible designate accompany and remain with younger student(s) at the bus stop.
c) Parents/Guardians or a responsible designate should ensure students are at the stop 3-5 minutes prior to pick time.  Bus Drivers may leave the stop at the stated time, to ensure students arrive at school in a timely manner.
d) Drivers will not knowingly leave a child unattended at a stop, but recognize that a spare driver may not know your child or with a large group there is not always acknowledgement of who goes with whom.
e) A note is required to be submitted to the school prior to boarding a school bus the child is not registered on.  Bus drivers are not required to transport students who are not registered for their route.
f) No person shall bring on the bus the following item(s):  animals (except “guide dog”), firearms, explosives, combustible materials or substances or anything of dangerous or objectionable nature or that might endanger the lives or safety of persons in the bus.

As a parent/guardian requesting transportation services for my child who is named above, I hereby agree to abide by PRSD Transportation Policy 8.31, section 'School Bus Rider Policy'. I further realize that the services provided are a privilege, not a right and may be suspended or withdrawn in the event I and/or my child fail to abide by the rules.

I have been made aware of and fully understand that I am ultimately responsible to get my child to and from the bus stop safely or to provide a responsible designate. It is my sole responsibility to inform the PRSD in a timely manner of address changes, drop off changes, health changes or any other changes that may affect the safe transportation of my child.

I fully understand that PRSD may enact emergency procedures if I or any of the emergency contacts listed on my child's school record not available to receive my child from Transportation Services and/or if the emergency contact(s) named on my child's school record is/are not available.

I understand that as per Administrative Procedure 181, The Peace River School Division may equip school buses with electronic recording devices ensuring student and driver safety.

All reasonable efforts are made by Board and PRSD staff and transportation operators to ensure the safety of every child involved in transportation services. Parents/guardians play a key role in ensuring the safety of their child by providing accurate information and ensuring each child is met by a responsible designated person at the end of every day.

Submitted by I acknowledge that transportation procedures will apply.

Last Name

First Name

Confidentiality Statement In accordance with the Personal Information Protection and Electronic Documents Act, Article 29, Paragraph (2), personal information requested in this form will assist in providing transportation services. The information is gathered in accordance with the Education Act in the Province of Alberta.

School Bus Registration Form for Current School Year

More than one student matches the criteria submitted. Please select the student to use

Use the following examples to help complete the address fields:

Parent/Guardian

Parent/Guardian 2

Sitter

Joint Custody

Joint Custody Sitter

Alternate/Interschool

Acknowledgment

PRSD Responsibility

Parent Responsibilities

<%= Resource: Campaigns_Prompt%>