Sacred Heart Band Home » Sacred Heart Band Step 1 of 3 33% Consent* I understand at any point of the school year if Southeast Public Transit experiences a loss in drivers, the youth rides will be the first to be affected. We will implement the two block radius of a school district bus stop then if that is not enough we will stop all youth rides.Consent* I read the Youth Rider Pamphlet and am in complete understanding with all rules outlined within it. This pamphlet can be found under the Documents tab at the top of the screen. Passenger InformationPassengers Name:* First Last (Paternal or Legal Last Name Only) Physical Address:* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth:*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender:* Male Female Email: (This will also be used for Fare Card balance notifications)* Ethnicity:*Select OneCaucasianHispanicAfrican AmericanNative AmericanOtherOther Ethnicity:* Band Class*6th Grade7th/8th GradeAdditional Comments: Legal Guardian InformationLegal Guardians Name:* First Last Physical Address:* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Number* Employer Information* Phone Number:*ConsentName:* First Last Phone:*Relationship to Rider:* ALL RIDES ARE NEEDED TO BE SCHEDULED ONE BUSINESS DAY PRIOR TO THE SCHEDULED RIDE DURING OFFICE HOURS M-F 7A-5P.Policies and InformationFARECARD AND PURCHASING FUNDS*Each rider will be required to have a farecard for rides. Please come to our office at 901 East 7th Street to pickup the farecard and load funds onto the card. This needs to be done before the first ride. After receiving the card, you may reload funds onto the card on our website, in office, or over the phone. I have read this statement. BULLYING WILL NOT BE TOLERATED*I understand any misconduct on the bus will result in a verbal warning to the youth transit rider and if the problem persists a parent and/or guardian will be notified. Misconduct may result in suspension depending on severity and/or whether or not a problem has persisted after verbal warnings. The length of suspension will depend on the seriousness of the misconduct. I have read this statement I understand that the drivers will wait 3 minutes before we No-Show your child and you will be charge a fee.* I have read this statement I hereby acknowledge that Southeast Public Transit has a no refund policy on tickets.* I have read this statement I understand that payment is to be made either in advance or upon boarding the bus.* I have read this statement I understand that all rides need to be scheduled by 4:30pm at least one business day prior to date of the ride, and that YT is unable to take a same day request.* I have read this statement I understand YT’s no show policy that if the bus arrives to pick up my child and they do not ride, I will be required to pay for the cost of the ride and that all request to cancel the ride must be called into our dispatch office before the bus arrives.* I have read this statement I understand that I am responsible for updating my personal information as needed (i.e. change of address or phone number).* I have read this statement I understand that YT reserves the right to refuse service.* I have read this statement I understand that as a parent/guardian for children Pre School to 6th grade are not outside when YT drops off my child, that YT will ensure they get inside the door of the facility. If the child cannot get inside facility YT will make an attempt to contact the parent/guardian and my child will remain on the bus until arrangements are made. If all attempt have failed to contact the Parent/Emergency Contact, YT will contact the local authorities.* I have read this statement If child damages bus, Parent/Guardians is responsible for damages.* I have read this statement Signature:*Printed Name of Signature or Who Completed the Form*