Transportation Information

All information must be filled in completely.  Applications WILL NOT be considered if any information is missing.  Bus rides are $1 each way. There are many factors that go into bus placement such as pick up and drop off address, pre-school location and time of class.  Therefore, we cannot guarantee spots on the Rainbow Route for any child.  We do our very best to get as many children on the bus as possible. 
 
At this point the final routes for the bus have been determined, so please note that your child will be put on a waiting list. The waiting list is reviewed weekly and the final route will ultimately change throughout the school year so you are still encouraged to apply.
If your child is not placed on the bus, will they still be able to attend preschool? *
What type of transportation are you needing? *
The pick up address is: *
The drop off address is: *
The child is currently registerd *
Days Needing Transportation (check all that apply) *

Parent Information

Emergency Information

Please list two people, other than yourself, who can receive the child and/or be notified in case of an emergency
Does the child have any allergies or need any special accommodations? *

Terms and Conditions of the Rainbow Route

-I am aware that my child is not guaranteed a spot on the Rainbow Route (you will only be notified by the United Way if your child is able to receive transportation services - if you are not notified, you are on the waiting list.)
 
-All information provided on this application is correct, and if anything shall change, I will notify the United Way of Mower County immediately
 
-I consent to Disclosure, Mutual Release, and Sharing of Private Information among the partners within the Rainbow Route Collaborative (United Way of Mower County, SMART Transportation, The Parenting Resource Center, and my child's school).
 
-I consent, on behalf of my child, to the United Way of Mower County and/or a United Way of Mower County approved media representative use of my child’s voice, photograph, video or likeliness in United Way’s campaign materials, internet, advertisements and other marketing and promotional materials. It is further understood that I consent, on behalf of my child, to the above without expecting payment or other reimbursement, and I release United Way of Mower County and its employees from any and all liabilities which may arise from the use of such material. It is understood that my child’s name/identity may also be used for these purposes.
 
-I am aware that if there are any behavioral issues, my child may be removed from the bus
 
-I am aware that if my child is placed on the Rainbow Route, it is my responsibility to notify SMART Transportation (855-762-7821) if my child is sick or not needing transportation for the day
 
-I am aware that all Rainbow Route staff are mandated reporters
I agree to the above Terms and Conditions *
I have fully discussed the above Terms and Conditions with the child's family *
Parent/Guardian Signature *
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Preschool Employee's Signature *
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