Registration Form

Parent/Guardian Full Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent's Email Address

Parent's Contact Number

Relationship to Kid(s)

Emergency Contact Name and Number

When Do You Need Service

Would You Like To List a 2nd Parent/Guradian

Kid(s) You Are Registering

Kid(s) Information

Kid's Full Name

Kid's Age

Date Of Birth

Food Allergies

Grade

Please choose grade based on when you need service to start

Booster Seat Required?

All Riders must meet minimum requirements by the TN Child Restraint Law

School Pick Up Location

Drop Off Location

Text Drop Off Verification

Select Yes if you would like a text when your kid is dropped off

Locations 3rd Registration

Additional Notes or Requirements For Your Kid(s)

Please list any additional special needs, planned alternative days when kid(s) does not need to use shuttle, etc.

Notices and Signature

Please Note that registering your kid(s) for After School Service does not guarantee their ability to become a rider. We work hard to accommodate every registration and will contact you directly to follow up with additional questions, approvals, or wait list options. In the event we cannot accommodate your kid(s), we will notify you promptly.

Parent/Guardian Signature

Clear Signature

Date

Registration Fee

There is a one-time nonrefundable fee for kid(s) registering for service.

Registation Fee

Fee: $25.00

Promo Code

Credit Card

Total

$0.00

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New Rider Registration

Kid(s) Information

2nd Kid Registration

3rd Kid Registration

4th Kid Registration

Notices and Signature

Registration Fee

Parent Links

Contact Us

Contact Us

New Rider Registration

Kid(s) Information

2nd Kid Registration

3rd Kid Registration

4th Kid Registration

Notices and Signature

Registration Fee

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Parent Links

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