Replacement Pass Form

Replacement Pass/Additional Pass

Students must have a valid bus pass to ride the school bus. If your student has lost or misplaced their pass please use the form below to order a replacement pass.

If your child needs an additional pass for reoccurring use of another route, you must request approval from the Program Manager; if there is room on the bus, approval will be granted.

The fee for replacement/additional passes is $15. Please allow 3 working days for delivery by US Mail.

Replacement Pass *

$15.00

Student First Name *

Student Last Name *

School *

Route # *

Bus stop *

Grade *

Service Requested *

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 abide by 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.