Printable Forms

 

2022-2023 Emergency Contact Form K-12

 

Name:__________________________ Birth Date:___________ Sex: M____ F____

Pick-Up Address:_______________________ Drop-Off Address:______________________

Special Needs (Medical or Other):_____________________________________________

Name of School or Day Care:_________________________________________________

School Start/End Time:________/________

Ride Start/End Date:________/_________

Ride Needed: Before School___ After School___  Days M__T__W__Th__F__ As Needed__

Consent for child’s photo to be use on NPPT’s Facebook Page and/or other media Y__N__

Mom’s Name:_________________________ Dad’s Name: :_________________________

Mom’s Employer:______________________  Dad’s Employer:_______________________

Home Phone:_________________________  Home Phone:_________________________

Work Phone:__________________________ Work Phone:__________________________

Cell Phone: ___________________________ Cell Phone:___________________________

Email:________________________________ Email:______________________________

Child’s Address: ____________________________________________________________

Emergency Contact:_____________________ Phone:______________________________

Daycare Contact:_______________________  Phone:______________________________

· If your child does not have proper bus fare, they will not be able to ride the bus

· North Platte Public Transit will cancel transportation after 3 consecutive “NO SHOWS”

· 24 hour advance notice to set up rides

· Bullying and uncooperative behavior will result in removal of your child from the schedule

 

I have read, understand, and agree to all terms and conditions.

Signature & Date:__________________________________________________

 

 

 

 

Advance Reservations are requested to allow for your student to get their needed pickup time!

Youth Transportation

No child will be transported unless an Emergency Contact Form is on file at NPPT.  This applies to all children riding the bus, regardless of the number of times a child will be riding.  This  form is for your child’s safety.

No rides can be charged.  If your child does not have correct change (our drivers do not carry change), they   will not be  able to ride the bus.  E Passes can be purchased over the phone with a debit card, by calling the transit office or by paying the driver with cash or check.

It is your responsibility to contact us regarding changes in your child’s schedule.  For safety reasons, we cannot take information regarding transportation changes from your child or daycare.

During morning pickup, it’s a tight schedule and the longest we will wait for the student is 3 minutes. They need to be watching out the window for us starting at 7am.  We might not be there right at 7am but they need to be watching and looking.

Buses will arrive at the schools at dismissal time and depart approximately seven minutes later.  Rides required after the bus departs will cost an additional fare.

Routes are determined by first come first serve and according to school times.

 

Seatbelts are required to be worn by all passengers, please make your child aware of this and that they need to get to their seat quickly and put their seatbelt on.

 

 

NO Bullying Allowed

Poor conduct, including bullying and foul language, will not be tolerated and could result in being banned from riding the bus.  A child’s bus ride should be a positive experience and negative behaviors jeopardize         everyone’s safety.

 

 

308-532-1370   Dispatcher/Reservations

1520 North Jeffers St

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Emergency Contact Form