Request to transport teen parenting child(ren) on the parenting bus

For the 2008-2009 school year

Requesting Parent ___________________________________ Grade _____ Campus _______________

Print all information in black ink.

[   ] Are You Currently Pregnant?…(if so)…Expected Due Date ___________________

Child 1 _________________________________________ DOB ______________ Weight ___________

Name                                                                           This is needed to determine restraint needs

Child 2 _________________________________________ DOB ______________ Weight ___________

Name                                                                           This is needed to determine restraint needs

In case of an emergency how can we contact you? __________________________________________

____________________________________________________________________________________

If we can't reach you, who else should we contact? __________________________________________

How? _______________________________________________________________________________

A current address and phone number must be kept on file at Transportation, in the Day Care and in your

Campus SASI computer records. Riders must phone Transportation each morning between 6 and 6:10 am

for the Parenting bus to pick you up. If you or your children are sick please do not spread your illness to

others on the Parenting bus. You, as the parent, are responsible for providing all care and clean up after

you & your children while on the parenting bus. All provided seating and restraints must be used while on

the Parenting bus according to TXDOT law. Other personal carriers/car seats may not be used.

Regular Bus Rider Contracts are also required for you to ride the Parenting bus and you may not ride more

than one bus during the school year. If you fail to appear on the Parenting bus you will become inactive.

You may not ride another bus until you provide Transportation with a new Regular Bus Rider Contract

and remove yourself from the Day Care bus rider list.

New contracts or changes require Transportation to have 3 days to make adjustments to the Parenting

Route.

Please keep a copy of this form for your records and forward the original to Transportation through the

Waxahachie ISD Day Care.

Transportation Phone 972.923.4632 - Fax 972.923.4743