Single Use One Trip Pass

SINGLE USE ONE TRIP PASS

This is the order form for a Single Use One Trip Pass which is valid for ONE ride on ONE specific date. To order multiple passes, please use the regular One Trip Pass Form.

One Trip Pass Rules: PLEASE READ!

One trip passes are non-refunable. TK, Kindergarten and 1st graders must be met by an adult in the afternoon. One Trip passes users must use existing scheduled stops.

ONE TRIP PASSES ARE NOT ACCEPTED ON FULL ROUTES.

SH 13 AM, OIS 10 AM/PM, OIS 15AM OIS 17 AM/PM, RH/JM 3AM/PM, 4 AM/PM and RH/JM 5 PM

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If you wish to purchase ONE Single Use One Trip Pass, please fill out the form below and make your credit card payment of $8.00. You will receive an email which MUST BE PRINTED AND GIVEN TO THE DRIVER. You will need to know the bus route and exact bus stop. Please refer to the bus schedules for this information.

Single Use One Trip Pass *

$8.00

Date of Use * +

Student First Name *

Student Last Name *

Grade *

Service Requested *

School *

Route # *

Bus stop *

Home Address *

Emergency Phone Number *

Parent Email address *

Confirm Email *

Initials *

My initials indicate my child has permission to ride the bus and use the bus stops listed and that my child will follow the Bus Rules and Safety Information sheet. Failure to follow the rules may result in suspension or expulsion. I accept all responsibility for the transportation of my child to and from the bus stops. I understand and agree that the Lamorinda School Bus Transportation Agency (LSBTA) does not provide supervision while waiting at the bus stop. I hereby release on behalf of myself and my child and agree to hold the LSBTA harmless from any liability or responsibility for injuries or damage arising out of or related to the use of the bus service.