Fillable Bus Enrollment Form 2015-2016 - Morgan County Schools printable pdf download

Morgan County Schools

Bus Enrollment Form 2015-2016

Student’s Legal Name____________________________Grade_____Birthdate___________________

Physical (911) Address___________________________City____________State______Zip________

Detailed Directions to your home_______________________________________________________

__________________________________________________________________________________

Father’s Name_____________________________Mother’s Name_____________________________

Home Phone_______________________________Home Phone_______________________________

Cell Phone_________________________________Cell Phone ______________________________

Emergency Contact__________________________Emergency Contact_________________________

Emergency Phone___________________________ Emergency Phone__________________________

Student’s School_____________________________ Homeroom Teacher_______________________

Bus #a.m. __________ Transfer? Y N

Bus Driver_______________________

Bus # p.m.__________ Transfer Y N

Bus Driver_________________________

Different Bus Numbers different days or different weeks? Please list all bus numbers & details below.

Times/Days.___________________________________________________________________________

Parents or designated responsible adults are required to escort and remain with Pre-K through 3

grade students when

boarding the bus in the morning and unloading on the return afternoon trip.

Names and phone numbers of persons near student’s residence who have consented to care for students if parents are not available.

NAME

PHONE #’S

RELATIONSHIP

____________________________________________________________________________________

CHECK ONE

______I permit the bus driver to unload my child(ren) at the bus stop if I cannot meet them. (CANNOT check if your child(ren) are

Pre-K to 3

grade)

______I will be at the bus stop myself or I will have a person listed below in my place to meet my child(ren).

Name______________________________________________ Phone___________________________

Please check if any of the following pertain to your child:_____Asthma

______Diabetes

______Heart Disease

______Seizures_____ Food Allergy _____Allergies- List:_________________________________________________

Medications taken – Name and Reason__________________________________________________

Doctor’s Name______________________________________Phone__________________________

Use the back of the form to share any other information needed. Students must return this form to be enrolled on the bus.

This form must be signed and returned within 3 days of receiving it. Confidentiality will be maintained. Students enrolled on

any Morgan County bus will be videotaped for the sole purpose of safety and discipline matters. These tapes are only reviewed

on an as needed basis by school officials who have a need to view them for safety or discipline matters.

Bus Enrollment Form 2015-2016 - Morgan County Schools