Beaufort Jasper EOC Head Start

Transportation Agreement
(Private Transportation Only)

Child Name:*

Parent name:*

What program option are you registering for?*

Center:*

I will transport my child to Head Start Center on a daily basis and I agree to the conditions stated below:

Arrival time should be between 7:15 AM and 7:45 AM.
My child will be in regular attendance at the Center.
When my child will be absent, I will call the Center by 8:15 AM.
I understand that I or the authorized person must sign my child in and out each day upon his/her arrival to or departure from the center.
I will stop by the office, pick up a pass, and sign in before taking the child to his/her assigned class.
When arriving at the Center with my child and the teacher states he/she cannot receive the child because he/she appears to be ill, I will take my child back home without an argument.
I further understand that my child will not be released to anyone other than the person(s) who I have authorized in writing to receive my child.
I or authorized responsible person will pick up my child each day by:
2:30 PM at Beaufort
2:45 PM at Sandalwood
2:30 PM at Davis (Pre-school & Early Head)
2:45 P.M. Leroy H. Gilliard
2:45 PM for Robertville (EHS)
2:30 PM at Ridgeland (Must pick child up in Car Riders Line)
2:30 PM at Hardeeville (Must pick child up in Car Riders Line)
2:30 PM at St. Helena (Pre-school & Early Head)
2:30 PM at Shanklin
I will notify Head Start in writing of any changes such as:
1. Change of address
2. Change of responsible receiver
3. Medical condition
4. Change of custody, restraining orders, etc.

I understand the following actions will be implemented if I am late to pick-up my child from his/her Center:

The Center staff will call the responsible receiver to pick the child up.
If the child is still at the Center 15 minutes after the designated time, the Center staff will call the Central Office and an Administrative staff may contact the Sheriff’s Department.

I confirm that I have read and understand this form. *

By checking this option, I choose to manually sign this form.

By checking this option, I prefer to have the system electronically sign this form for me.

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Parent Signature

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