Youth Information Sheet

    Child Information

    Gender*MaleFemale

    Parent Information

    Day Care Information

    If origin or destination is a daycare, a PARENT/DAY CARE PROVIDER SIGNOFF will need to be completed prior to beginning service.

    Days*MondayTuesdayWednesdayThursdayFriday

    One-way tripRound-trip

    Emergency Contacts

    List of people the child can be left with if you or your daycare provider are not available:

    Please read and sign

    FARES: Call 605-624-7433 to purchase over the phone. Drivers will hand out the passes the first day of service.

    I, the parent or guardian, agree to allow Vermillion Public Transit provide transportation for my child. I will notify Vermillion Public Transit as soon as possible of any scheduling changes or cancellations. I have reviewed the VPT Passenger Handbook.