Kats Transportation Permission

KATS TRANSPORTATION PERMISSION

SIGN AND RETURN THIS SHEET TO YOUR TEACHER AS YOUR APPLICATION TO RIDE KATS BUS.

I understand that riding the bus is a privilege. A cooperative team effort is the key that will make it possible to provide a safe and more efficient transportation program.

PARENT/GUARDIAN SECTION

______Student’s Name Date of Birth School/Program

______Parent or Guardian (Print) Signature

______Home Phone Work Phone

______Pick up Address Zip Code Subdivision/Apt Name

______Drop off Address Zip Code Subdivision/Apt Name

Does your child have a physical condition the driver needs to be aware of? Example: diabetic, asthmatic, epileptic, etc: ______

Do you have any suggestions on what would be helpful to your child if a condition should arise while on the bus? ______

KI BOIS Head Start staff supervises your child once your child boards the bus in the morning until your child exits the bus in the afternoon.

NOTE: All bus riders are subject to being filmed by a video camera while on the bus. The parent/student permission form must be signed and returned to the Head Start Center and a copy will be given to KATS Transportation to be kept on file.

AM______PM______Afterschool______

Monday______Tuesday______Wednesday______Thursday______Friday______

KHS-302A-17