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LTD Youth Bus Pass Permission - Spencer Butte Middle
All 4J students are entitled to a free, annual transit pass from Lane Transit District (LTD) with a $200+ value. Return this signed permission form to get yours now.

Important details:
Acceptance and use of an LTD pass is voluntary.
A parent may ask the school to deactivate their student’s LTD pass at any time.
Elementary and middle students must have parent permission to receive an LTD pass through the school. High school students may receive an LTD pass without parent permission – however, parents may opt their student out of the program or deactivate the pass by notifying the school.
LTD student passes will need to be renewed once a year, but parents will sign this permission form just once. By signing this form, a parent is authorizing the school to reissue or renew the student’s LTD pass for as long as the student remains enrolled in 4J.
The district does not supervise or control LTD-provided transportation, and assumes no responsibility for a student’s use of an LTD bus pass. Schools, in collaboration with LTD, will distribute and renew the passes.
Parents are strongly encouraged to teach their children about safe and appropriate use of public transportation.
This program may be ended or modified at any time. The district will notify parents of major program changes.

If you would like your elementary or middle school student to receive a free youth bus pass, please complete and submit this form.

If you do not wish to give permission for your elementary or middle school student to receive a pass, please do not submit this form.

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I have read and agree to the terms above and I give permission for my child to receive a free LTD youth bus pass and for the school to issue new or renewed passes for as long as my child is enrolled in 4J schools. *
Student Name *
Student Date of Birth *
Student Grade *
Parent/Guardian Name *
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