Youth Registration Form

Legal Guardian Information

Legal Guardians Name:*

First Last

Physical Address:*

Street Address City State ZIP Code

Phone Number*

Is Mailing Address same as Physical Address?*

Yes
No

Employer Information*

Phone Number:*

Emergency Contact Information

Name:*

First Last

Phone:*

Relationship to Rider:*

Daycare Facility

YT will be transporting my child to or from a Daycare facility?:*

Yes
No

Daycare Name:

Daycare Address:

Street Address City

Daycare Phone:

Passenger Schedule

Will the rides be scheduled or as needed?

Scheduled (same day, time, and location every week)
As Needed (varies daily/weekly)

Start Date:

Days 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 Location

Name of Business, School, Daycare, or Home:

Street Address City

Drop off Location

Name of Business, School, Daycare, or Home:

Street Address City

Do they need a return trip?

Yes
No

Return Trip Pickup Location

Name of Business, School, Daycare, or Home:

Street Address City

Return Trip Drop off Location

Name of Business, School, Daycare, or Home:

Street Address City

Any Additional Information:

Policies and Information

FARECARD AND PURCHASING FUNDS*

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*

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 the drivers will wait 3 minutes before we No-Show your child and you will be charge a fee.*

I have read this statement

I hereby acknowledge that Southeast Public Transit has a no refund policy on tickets.*

I have read this statement

I understand that payment is to be made either in advance or upon boarding the bus.*

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 YT is unable to take a same day request.*

I have read this statement

I understand YT’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.*

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).*

I have read this statement

I understand that YT reserves the right to refuse service.*

I have read this statement

I understand that as a parent/guardian for children Pre School to 6th grade are not outside when YT drops off my child, that YT will ensure they get inside the door of the facility. If the child cannot get inside facility YT 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, YT will contact the local authorities.*

I have read this statement

If child damages bus, Parent/Guardians is responsible for damages.*

I have read this statement

Signature:*

Printed Name of Signature or Who Completed the Form*

All registration forms received during the week before 12PM Friday will have a delayed starting date. For example, any rides received during the week of August 21st-25th will begin on August 28th. This is only temporary until we get through the first couple weeks of school.

Step 1 of 3

Passenger Information

Legal Guardian Information

Emergency Contact Information

Daycare Facility

Passenger Schedule

Pickup Location

Drop off Location

Return Trip Pickup Location

Return Trip Drop off Location

Policies and Information

Hours of Operation

Yankton

Vermillion

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