Parent/Custodian Name (required)

    Apartment

    Email Address

    Phone (Home) xxx-xxx-xxxx

    Phone (Cell) xxx-xxx-xxxx

    Phone (Work) xxx-xxx-xxxx

    Address

    Postal Code (required)

    Major Intersection (required)

    Student's Name (required)

    Entering Grade (September, 2021) (required)

    Medical Condition

    Payment

    * $300.00 non-refundable registration fee due with registration*

    Method of Payment (Please check one)

    *Please note all credit cards will be charged an additional 2%*
    *Make cheques payable to Next Stop School Busing*