Editing previous response:

Please fix the highlighted areas below before submitting.

BUS RIDER REGISTRATION FORM

Please complete the form below. Required fields marked with an asterisk *

Bus Rider Registration Form

School Year 2025-2026

Please fill out this form completely, sign it, attach the fee, and submit it to the school’s administrative office. Space is limited and is based on a first-come, first-served basis. The bus fee for students who ride from the North Hills campus is $250/student roundtrip and $200 for one way (either morning or afternoon). The bus fee for students who ride from La Crescenta is $350 roundtrip and $275 for one way (either morning or afternoon)

Note: The bus leaves La Crescenta/Glendale at 7:00 am and will arrive at the North Hills Campus around 7:30 am. It will depart from North Hills by 7:35 am. For the afternoon return service, the bus will depart Encino at 3:30 pm, drop off at North Hills by 3:50 and arrive at La Crescenta/Glendale by 4:30 pm.

Student's name

Answer required for "Student's name"

Grade Level

Answer required for "Grade Level"

Service Requested

Answer required for "Service Requested"

North Hills Campus

La Crescenta/Glendale

Morning Ride Only

Afternoon Ride Only

EMERGENCY CONTACT

Parent or Guardian 1

Name and Last Name

Answer required for "Name and Last Name"

Relationship

Answer required for "Relationship"

Home Phone No.

Answer required for "Home Phone No."

Work Phone No.

Answer required for "Work Phone No."

Cell Phone No.

Answer required for "Cell Phone No."

Email Address

Answer required for "Email Address"

Parent or Guardian 2

Name and Last Name

Answer required for "Name and Last Name"

Relationship

Answer required for "Relationship"

Home Phone No.

Answer required for "Home Phone No."

Work Phone No.

Answer required for "Work Phone No."

Cell Phone No.

Answer required for "Cell Phone No."

Email Address

Answer required for "Email Address"

Note: Students who are late will not be allowed on the bus.

Students must be courteous to the driver and follow his directives at all times.
Students shall enter and occupy their seats in an orderly manner while the bus is in motion.
Students shall not obstruct the aisle with their legs, feet, or other objects.
Students shall refrain from behavior that distracts the driver. Talking in a loud voice, yelling, singing, whistling, scuffling, and throwing objects are examples of distraction and inappropriate behavior.
Students shall not put hands, arms, heads, or any part of the body out of the bus window. They should not throw any objects from the bus.
Students shall not litter the interior of the bus, tamper with bus equipment, damage or deface the bus, nor damage any property near or at bus stops.
Students shall not bring animals, birds, reptiles, or insects on the bus.
Students shall not chew gum, eat, or drink while on the bus.

Disciplinary Provision

The disciplinary rules and regulations of the School apply to school bus riders. Students must also follow the directives of the bus driver. The bus driver has the authority to reprimand and relay any misconduct to administration where disciplinary consequences will be given, including and not limiting it to losing bus riding privileges.

Medical Release Statement

In the event the School is unable to get in touch with me, I grant my consent to the School to provide emergency medical treatment to my child by an emergency medical team/doctor/paramedic and to get in touch with the emergency contacts on file.

Hold Harmless Provision for Off Campus Activities

I agree to hold the school harmless of any liability during off campus activities resulting from change of plans and/or itineraries, travel delays, unforeseen additional expenses, and deviations from the original plan. I agree to hold the school harmless of any liability resulting from injuries sustained or loss of property caused by my child while riding the bus.

Parent/Guardian Name

Answer required for "Parent/Guardian Name"