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MPSD Bus Registration

Parent Information:

Surname:  
First Name:  
Address:  
City:  
Postal Code:  
Home Phone:  
Alternate Phone:
Email Address:   

Students being bused from this address:

Surname:   First Name:   School:  Date of Birth: DD/MM/YY  Grade:   Gender:   Cross Boundary
Surname:    First Name:  School:  Date of Birth: DD/MM/YY Grade:  Gender:   Cross Boundary
Surname:  First Name:  School:  Date of Birth: DD/MM/YY Grade:  Gender:   Cross Boundary
Surname:  First Name:  School:  Date of Birth: DD/MM/YY Grade:  Gender:   Cross Boundary
Cross Boundary: Not eligible for Waivers

Student Medical Alert:

Please fill out the section below ONLY if it applies to your child.
Child's First Name:   Diabetes  Epilepsy  Anaphylactic Allergy to:   Wheelchair  Other Mobility Issue:   Other (ie. Special Needs):