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Appendix - Operator's Children on Bus Request



<contractor address>




Having your child(ren) on the bus with you is a privilege. Having your child(ren) on the bus must not interfere with your commitment to the safety of your students and your ability to provide a high level of customer satisfaction. You must be prepared to make arrangements for childcare for your child(ren) when meetings are scheduled at the office or school(s). It does necessitate that you read and comply with the following conditions. Signing this request form indicates that you have read and fully understand the conditions.


      (a)  Your child must be secured in a child seating assembly that meets the requirements of the Highway Traffic Act.

      (b)  Your child must not occupy a seat required by a pupil who is regularly transported on the bus.

      (c)  Your child must follow all of the rules of conduct for students as set by the Company and the School Division.

      (d)  Your child must not disrupt the safe operation of the bus.

      (e)  The Principal(s) must be advised when your child is accompanying you on the bus.


This request is for the Preschooler(s) listed below:


Last Name

First Name

Date of Birth








I have read and agree to abide by the conditions stated above.


I understand that the permission from <contractor> for my child(ren) to accompany me on the bus while transporting students may be withdrawn at the discretion of <contractor>, or at any time if Northern Gateway Public Schools makes a request for a withdrawal of the privilege.


Operator’s Name:  ________________________________ Route #: __________________


Signature:  ______________________________________ Date: _____________________







Approved By: Name: _______________________________


                       Signature: ____________________________ Date: __________________


Submitted to Northern Gateway Public Schools:         Date: ________________________