Service Information

When would you like to use the Canterbury School bus service?*

Morning Only Afternoon Only Morning and Afternoon

How many children will ride the bus?*

1 2 3 4

Student Information

Student 1 First Namerequired

Student 1 Last Namerequired

What grade will this student be entering for the 2022-23 academic year?required

Student 2 First Namerequired

Student 2 Last Namerequired

What grade will this student be entering for the 2022-23 academic year?required

Student 3 First Namerequired

Student 3 Last Namerequired

What grade will this student be entering for the 2022-23 academic year?required

Student 4 First Namerequired

Student 4 Last Namerequired

What grade will this student be entering for the 2022-23 academic year?required

Parent Information

Parent/Guardian Namesrequired

Please include first and last names.

Name of Addition

Primary Emailrequired

Please use lowercase only.

Primary Phonerequired

Please use numbers only; no special characters.

Address Line 1required

Address Line 2

Cityrequired

Ziprequired

Joint Location Preferences/Notes/Comments

Agreement

Conduct Agreement*

By registering for Bus Service, I understand that Canterbury School retains the right to suspend or dismiss from ridership any student whose conduct is deemed unsatisfactory or whose influence does not serve the best interests of the school. In the event of suspension or dismissal, no refund of the bus fee will be made.

Yes No

Electronic Signaturerequired

My electronic signature signifies the information provided is accurate and that I have provided information, consent, authorization or agreement where indicated.