Transport Admission Form 2011/2012

If you would like us to pick up your child(ren) before school and bring them back after school with our bus service, please fill out the form below and we will contact you.

Please note that only families that are a paying member of the Parents Association can use the PA's bus services.

From
First Name Parent
Last Name Parent	*
Address + nr	*
Postal Code	*
Town	*
Home Phone Number
Cell Phone Number	*
Exchange my phone number with other parents on the same bus	Yes No
Email Address	*
Name of the person paying the invoice
First Name Child 1	*
Last Name Child 1	*
Date of Birth Child 1	*
Class Child 1	*
Language Child 1	*
First Name Child 2
Last Name Child 2
Date of Birth Child 2
Class Child 2
Language Child 2
First Name Child 3
Last Name Child 3
Date of Birth Child 3
Class Child 3
Language Child 3
First Name Child 4
Last Name Child 4
Date of Birth Child 4
Class Child 4
Language Child 4
Start using the bus from this date:	*
Choose Which Bus Line & Stop	*
Check Which Days Of The Week	Monday to school Monday back home Tuesday to school Tuesday back home Wednesday to school Wednesday back home Thursday to school Thursday back home Friday to school Friday back home *
Comments

By clicking the save button you agree to these terms and conditions:

I agree with the Transport Agreement
The Parents Association is not responsible, nor legally liable, for accidents during the transport of my children.
I'm responsible for my child(ren) during transport (see bus rules).
I can't hold the Parents Association responsible for the transport or claim any right in order to exclude my own responsibility.
I oblige myself to pay the invoices for transport before the due dates.