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Transportation Form
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471 kb
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Greenwood Unit - After-School Program Van/Walker Transportation Form
For more information call
361-853-2505
or email
charris@bgccb.org
*
Indicates required field
School
*
Member Name
*
Grade
*
Club ID#
*
I,
(Parent/Guardian)
, grant permission for my child listed below to be transported as part of the Boys & Girls Clubs of the Coastal Bend’s After-School Program.
Vehicle Transportation:
A monthly fee of $25.00 per child per school ($10 each additional child at the same school) is payable to BGCCB. Payment is required to reserve your child’s spot. PAYMENTS MUST BE MADE BY THE 25TH OF THE PRIOR MONTH.
I,
(Parent/Guardian)
, understand that I am responsible for picking up my child from the Club by 6:00pm Monday through Friday on regular school days. If late fees are not paid in full I understand my child will not be picked up from school or be allowed in the Club until fees are paid.
Walking Transportation:
There is
no fee
for students who are walk from Crockett Elementary. Students are required to meet our staff at the front of the building for supervised walking transportation.
I, (Parent/Guardian), hereby release the Boys & Girls Clubs of the Coastal Bend of any liability in the case of any accident, injury, dismemberments, and/or death. I also authorize consent to emergency medical treatment for my child as a member of the Boys & Girls Clubs of the Coastal Bend. I understand that the Boys & Girls Club will make all reasonable efforts to contact me and provide me with notice in the event that my child requires emergency medical treatment. In the event that the Boys & Girls Club cannot contact me and give notice, I understand that I am hereby authorizing the Boys & Girls Clubs of the Coastal Bend and its representatives to consent to such treatment on my behalf. I understand that the Boys & Girls Club will seek necessary emergency treatment for my child in the event my child is injured or harmed while in route.
Transportation Rules & Expectations:
Club must be notified one hour PRIOR to school dismissal if child will not be picked up.
Child must maintain 70% (3x per week) attendance rate to remain in program.
Child must be at school-assigned pick-up location on time. Club van will depart for school within 10 minutes of arrival.
While in the Club van, children are not allowed to eat, drink, chew gum, or distract driver with inappropriate behavior.
Children are expected to follow instructions of driver. We expect children to remain seated until arrival at the club.
There are consequences to not meeting transportation expectations, including but not limited to removal from transportation service.
Parent/Guardian Electronic Signature (Transportations Form)
*
Contact/Emergency Phone#
*
Date (MM/DD/YYYY)
*
Alternate Phone#
*
Submit
Home
About Us
Boys & Girls Clubs of America
Our Team
Our Board
Careers
Policies
Our Clubs
Registration
>
Flour Bluff - Summer
Greenwood - Summer
Early Learning Center
Greenwood - Spring
Flour Bluff - Fall
Ingleside - Fall
Youth Athletics
MyFuture Login
Events
Beads, Bets, & Beignets
Serve It Forward Pickleball Champions
Donate
Wish List
Kayak Raffle Payment