Registration Form

This form is used as a pre-registration. After receipt, you will be contacted by our office to determine space availability and complete the registration process. Please note, we require a $35 non-refundable registration fee per family, per year. This will secure your child(ren)'s seat on the shuttle. Please contact us if you have any questions at (972) 987-0346. To terminate contract, our cancellation form must be completed and submitted in accordance with our Terms and Policy Agreement.

Parents Infomation
Parent or Guardian 1 *
Parent or Guardian 1
Parent or Guardian 2
Parent or Guardian 2
Cell Phone 1 *
Cell Phone 1
Cell Phone 2
Cell Phone 2
This will allow for text notifications
Billing Address *
Billing Address
Child Information
Child Name *
Child Name
Birth Date *
Birth Date
Drop Off Address
Drop Off Address
If different from billing address
Medical and Other
If more than one student is needing services
Insurance Information
Subscriber’s Name *
Subscriber’s Name
Subscriber’s Birthdate *
Subscriber’s Birthdate
Work Phone *
Work Phone
In Case of an Emergency
We will contact the parents first, this information will be used if we are unable to reach the above parties
Authorized on Account *
Authorized on Account
Contact Number *
Contact Number
Create An Account
Statement of Compliance *
Check as a Statement of Compliance
I agree to all Terms and Policies *
By checking this field I agree that I have read the Terms and Policies.
Today's Date *
Today's Date
Start Date Requested
Start Date Requested