Transportation Contract Form printable pdf download

Transportation Contract

2015-2016 School Year

Deadline for contracting service for the 2015-2016 School Year is April 17, 2015. Contracts are honored on

a first-come, first-served basis with current students and siblings given priority until April 17, 2015.

Notification of service will be confirmed for round-trip contracts by May 8, 2015 and for one-way contracts

by June 12, 2015.

(please print legibly)

Student’s name ______________________________

Grade _____

Student Cell Phone # _______________

Student’s name ______________________________

Grade _____

Student Cell Phone # _______________

Student’s name ______________________________

Grade _____

Student Cell Phone # _______________

Address ____________________________________________________________________________________

Street

City

Zip

Home phone _____________________

Father/Guardian’s

work phone

_____________

cell phone ____________

other__________

Mother/Guardian’s

work phone

_____________

cell phone ___________

other _________

Location/Route:

___ St. Paul/Beach

___ Our Lady Star of the Sea

___ St. Joseph/Mandarin

___ Fernandina Beach

___ Atlantic/Girvin Rd. ___ Jax Golf & Country Club

___ Holy Family/Baymeadows ___ Yulee

___ Julington Creek

___ St. Patrick

___ Orange Park

___ Westside tentative route - minimum (10) contracts required

Ridership:

___ One-way (AM or PM only – circle one)

___ Round trip

Contact school for short-term agreements.

We, the undersigned parents, guardians or legal representatives hereby request that Bishop Kenny High

School, Inc. allow our child(ren) to participate in the transportation program for the 2015-2016 school year. The

undersigned parents, guardians or legal representatives hereby consent to the participation of their child(ren)

named above in the transportation program.

Bishop Kenny High School, Inc. will provide transportation from August 12, 2015-May 27, 2016 for 180

school days from designated pick-up site to Bishop Kenny High School in the morning and from Bishop Kenny High

School to designated drop-off site in the afternoon.

All information included on the Application for Admission for the 2015-2016 school year will be used and

applied to this Contract.

All rules, policies and procedures outlined in the 2015-2016 Parent and Student

Handbook, as well as the Transportation Program Handbook, are in effect for students during their participation in

the transportation program. All infractions, in addition to any possible consequences outlined in the handbooks, will

be referred to the Dean of Students who has the right to dismiss a student from the program. If a student is

dismissed from the program, there are no refunds.

Transportation will be provided by and take place under the guidance and supervision of employees of

Bishop Kenny High School, Inc. If you request that your child(ren) participate, please read, complete, sign and

return this contract which includes your consent, as well as a full release of liability. As parent or legal guardian,

you remain fully responsible for any acts of the named student(s).

For and in consideration of the student(s) being allowed to participate in this program, and other valuable

consideration, the undersigned parents, guardians or legal representatives, on behalf of the student(s) and the

student’s parents, personal representatives, assigns, heirs, and next of kin, do hereby release and hold harmless

Bishop Kenny High School, Inc., its employees and agents of said parties engaged in this particular program, and

their personal representatives or assigns, from any loss or damage on account of any injury to the person or the

personal property, of the student(s), or death, caused by negligence or otherwise, while the student(s) are engaged

in the bus transportation program. The undersigned expressly agree that this release, waiver and indemnity

agreement is intended to be as broad and inclusive as permitted by the laws of the State of Florida, and that if any

Transportation Contract Form

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