Childcare Request Form

The Kenston Board of Education realizes that it may be necessary to provide an alternate transportation location for student(s) that require child care. This must be a consistent schedule. 

*** Please note that you may only make 1 change in a school year. ***

In accordance with Board policy, transportation to and from a child care provider will be based on the following criteria:

1. For service to start at the beginning of the year, the completed form must be received by the Transportation Department prior to August 9th.  Forms received after August 9th will take a minimum of five (5) working days to go into effect after the first day of school. 

2. Service is for the entire school year.

3. The location of the child care provider must be located within the Kenston Local School District.

4. All students must have a Child Care Request Form on file in order for transportation services to begin.

5. This form takes the place of a permanent bus pass.

6. All changes must be made using this form. If you have to change something keep in mind you must go back to this form and only one change can be made after your original request.  No verbal requests will be taken.  

7. Child care service is for grades PreK-5. 

TRANSPORTATION REQUEST FORMS ARE ONLY EFFECTIVE FOR THE CURRENT SCHOOL YEAR.
A new form must be completed each school year.

* Required
Sign in to Google to save your progress. Learn more
Email *
Clear selection
Student's Last Name *
Student's First Name *
Student's School *
Student's Grade *
Child care Provider Morning: Please note if you choose a private residence that home must be in the Kenston Local School District. We only guarantee services from the certified daycare centers listed below.  
Clear selection
Child care Provider Afternoon:  Please note if you choose a private residence that home must be within  the Kenston Local School District. We only guarantee services from the certified daycare centers listed below.    
Clear selection
Private Residence (Someone's Home): If choosing a private residence, you must provide: The person's name, address and phone number. This may not be multiple locations. One location per family. 

*****If using a private provider have a backup plan as most of our routes are full. Even if you have used this in the past you may not get the approval if we do not have the room. Again this is all based on the number we can legally and safely transport. There is a good chance we will not be able to accommodate this option. ******

Please note that this is subject to approval based on the pattern of the route, stop safety, and seat availability. This is not a guarantee of stop approval. 

This is only for a private residence within the Kenston School District service area.
Campus Shuttle- Which Building are they coming from? STAFF ONLY
Campus Shuttle- Which Building are they going to? STAFF ONLY
Pick up drop off at Childcare Provider *AM Bus pick-up, PM drop off or both AM/PM *
Days of the week attending morning daycare *
Required
Days of the week attending afternoon daycare *
Required
Parent's Last Name *
Parent's First Name *
Parent's Cell Phone Number *
Parent's Work Phone Number *
Due to complexity of our routing you may only make 1 change in a school year for child care purposes.  All changes must be in writing. If you have to change something keep in mind you must come back to this form. Only one change can be made after your original request.  No verbal requests will be taken at the building or in the transportation office.       *
Required
If using a private provider, have a backup plan as most of our routes are full. These may not be approved, even if you have used this in the past.  Again, this is all based on the number we can legally and safely transport. Reminder, Kenston offers Boomer Take off in the morning and Boomer landing in the afternoon. There is  a chance we may not be able to accommodate a private provider. *
Required
Signature and acknowledgement
I am requesting that my child (listed above) be transported to/from locations other than school and my residence. I understand that the alternate location(s) will be permanent address for pick up/drop off and be located on a regularly established bus route at the time of day that I am requesting service.

I hereby release the Kenston Local School District, its Board of Education, its officers and employees from any liability which may result from complying with my request for transportation of my child to/from a location other than school and my residence. As I am also authorizing this address to be a safe location for them at all times. 

I acknowledge that once my child is transported to/from the designated pick up/drop off point, I assume full responsibility for the safety and welfare of my child. I will be certain that my child knows the destination each day and also knows the backup plan at each location in the event that my child finds no one available at the destination. Again, I have designated as this being a safe address at all times. I will be sure my child knows their schedule. 

It is suggested that the child care provider meet your child at the bus stop. All students are to be at their assigned bus stop 5 minutes prior to the scheduled pick up time. 
Your name indicates you have read and acknowledge the above statements and information. *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Kenston Local Schools. Report Abuse
Google Forms