Beaufort Jasper EOC Head Start

Transportation Permission Agreement

Child Name:*

Parent name:*

What program option are you registering for?*

Center:*

I give Beaufort-Jasper EOC Head Start permission to transport my child to the Center, to the Responsible Receiver, home, on field trips, and any other away from the center activities/services.

I will be at the bus stop to put my child on the bus in the morning and to receive him/her from the bus in the afternoon. I understand I am responsible for giving a written and signed notice to the bus driver prior to changing the following:

Responsible Receiver(s)
Pick-up/Drop-off point
Updates to Parent/Guardian contact information

I understand the responsible receiver must be an adult, have picture identification and know the family password/code. I agree to attend Safety Education Training session for parents within the first thirty days of school.

Pedestrian Safety
Bus Evacuation
Bus Safety

A Head Start Representative has explained to me the following penalties for not being at home or at the bus stop to receive my child:

1st Offense

A parent conference will be scheduled.

2nd Offense

A multi-team conference will be scheduled.(Family Service Department and Transportation Specialist) .

3rd Offense

The Sheriff or Police Department will be called to Pick–up your child from the Central Office. A child abuse and neglect report will be submitted to the Child Protective Services at the Department of Social Services.

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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