Brevard Academy Bus Rider Registration Form
Please complete the following registration form for students needing bus route service for 2018-2019. Up to four students can be added here. Parents will be notified via email if your student(s) have a space for the requested route(s) and will include a Bus Rules/Pick Up Authorization which will need to be signed and returned (more information will be included in the packet) If you have any questions, please contact Mrs. Best at kbest@brevardacademy.school The bus schedule can be viewed at http://brevard.teamcfa.school/student-life/bus-information/

Parent Contact Email Address: *
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Student #1 Name: *
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Student #2 Name:
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Student #3 Name:
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Student #4 Name:
Your answer
Student #1 Grade Level: *
Student #2 Grade Level:
Student #3 Grade Level:
Student #4 Grade Level:
Student 1: Which bus route would you need your child to ride? (Bus routes/stops may change dependent upon the school's needs) If your child needs to ride different buses on different day please check ALL that apply. *
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Student 2: Which bus route would you need your child to ride? (Bus routes/stops may change dependent upon the school's needs) If your child needs to ride different buses on different day please check ALL that apply.
Student 3: Which bus route would you need your child to ride? (Bus routes/stops may change dependent upon the school's needs) If your child needs to ride different buses on different day please check ALL that apply.
Student 4: Which bus route would you need your child to ride? (Bus routes/stops may change dependent upon the school's needs) If your child needs to ride different buses on different day please check ALL that apply.
Parent/Guardian #1 Full Name *
Your answer
Parent/Guardian #1 Cell Phone *
Your answer
Parent/Guardian #1 Home Phone *
Your answer
Parent/Guardian #1 Work Phone *
Your answer
Parent/Guardian #2 Full Name *
Your answer
Parent/Guardian #2 Cell Phone
Your answer
Parent/Guardian #2 Home Phone
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Parent/Guardian #2 Work Phone
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Emergency Contact #1 Name *
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Emergency Contact #1 Phone Number *
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Emergency Contact #2 Name *
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Emergency Contact #2 Phone Number *
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Comments/Questions?
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