Youth Registration Form Home » Youth Registration Form Registrations are OPEN! Step 1 of 3 33% Service Consent(Required) 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.Photo Consent(Required) I give permission for Southeast Public Transit to photograph or video my child during transit-related activities. These images may be used for marketing and promotional materials, including but not limited to social media, newsletters, flyers, and the Southeast Public Transit website. I understand that my child’s name will not be used without additional consent.Youth Pamphlet Consent(Required) 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.Contact Information(Required) I acknowledge that is is my responsibility to provide SEPTransit with accurate and up-to-date contact information. I understand that if staff are unable to reach me regarding my child's rides due to non-working phone number or email address, services may be suspended until current contact information is provided. Passenger InformationPassengers Name:(Required) First Last (Paternal or Legal Last Name Only) Physical Address:(Required) Street Address City Date of Birth:(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender:(Required) Male Female Email: (This will also be used for Fare Card balance notifications)(Required) Ethnicity:(Required)Select OneCaucasianHispanicAfrican AmericanNative AmericanAsianPassenger Walk On or Use a Mobility Device?(Required) Walk On Mobility Device School(Required)BeadleHeadstartLincolnSacred Heart MiddleStewartSt. BensSt. John's PreschoolTrailhead Learning Center Morning PreschoolTrailhead Learning Center Afternoon PreschoolTrailhead Learning Center JrK & KindergartenYankton Middle SchoolYankton High SchoolUSD Head Start Boys & Girls MorningUSD Head Start Boys & Girls AfternoonUSD Headstart Center for Children & FamiliesUSD Headstart VucurevichAdditional Comments: Legal Guardian InformationLegal Guardians Name:(Required) First Last Physical Address:(Required) 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(Required)Is Mailing Address same as Physical Address?(Required) Yes No Employer Information(Required)Phone Number:(Required)Emergency Contact InformationName:(Required) First Last Phone:(Required)Relationship to Child:(Required)Daycare FacilitySoutheast Public Transit will be transporting my child to or from a Daycare facility?:(Required) Yes No Daycare Name:Daycare Address: Street Address City Daycare Phone:Passenger ScheduleWill the rides be scheduled or as needed?(Required) Scheduled (same day, time, and location every week) As Needed (varies daily/weekly) Start Date:MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Days Needing a Ride: Select All Monday Tuesday Wednesday Thursday Friday ALL RIDES ARE NEEDED TO BE SCHEDULED ONE BUSINESS DAY PRIOR TO THE SCHEDULED RIDE DURING OFFICE HOURS M-F 7A-5P.Pickup LocationName of Business, School, Daycare, or Home:(Required) Street Address Drop off LocationName of Business, School, Daycare, or Home: Street Address Do they need a return trip? Yes No Return Trip Pickup LocationName of Business, School, Daycare, or Home:(Required) Street Address Return Trip Drop off LocationName of Business, School, Daycare, or Home:(Required) Street Address Any Additional Information:Policies and InformationFARECARD AND PURCHASING FUNDS (Yankton Location Only)(Required)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(Required)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 as a parent/guardian for children Pre School to 4th grade are not outside when SEPTransit drops off my child, that SEPTransit will ensure they get inside the door of the facility. If the child cannot get inside facility SEPTransit 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, SEPTransit will contact the local authorities.(Required) I have read this statement I understand that the drivers will wait 3 minutes before we No-Show your child and you will be charged a fee.(Required) I have read this statement I hereby acknowledge that Southeast Public Transit has a no refund policy on tickets or farecard funds.(Required) I have read this statement I understand that payment is to be made either in advance or upon boarding the bus. If the child does not have their fare card or cash, they will be denied the ride and charged the ride rate depending on the location of pickup.(Required) 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 SEPTransit is unable to take a same day request.(Required) I have read this statement I understand SEPTransit’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.(Required) 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).(Required) I have read this statement If child damages bus, Parent/Guardians is responsible for damages. Charges will need to be paid prior to the passenger riding after the incident.(Required) I have read this statement I understand that SEPTransit reserves the right to refuse service.(Required) I have read this statement Signature:(Required)Printed Name of Signature or Who Completed the Form(Required)