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BUS AUTHORISATION
Step
1
of
5
20%
Transport Authority Form - Regular Transportation
Location
(Required)
Bluebird Childcare - 36 Clydebank Avenue, Busselton WA 6280
Bluebird Central: 5 Edward Street, Busselton WA 6280
Bluebird Busselton: 15 Albert Street, Busselton WA 6280
Bluebird Margaret River: 36 Fearn Avenue, Margaret River WA 6285
Bluebird Margaret River OSHC - St Thomas More Primary School, 30 Wallcliffe Road, Margaret River WA 6280
Service Enrolled At
Long Day Care
Out Of School Hours Care
Number Of Children Requiring Transport
(Required)
1
2
3
4
Home & School Drop Off / Pick Up
Home Pick Up
I require my child to be picked up from home
Which Days Do You Require Home Pick Up?
Monday
Tuesday
Wednesday
Thursday
Friday
Home Collection Address
Street Address
Suburb
Post Code
Home Drop Off
I require my child to be dropped off at home
Which Days Do You Require Home Drop Off?
Monday
Tuesday
Wednesday
Thursday
Friday
Home Drop Address
Street Address
Suburb
Post Code
School Drop Off
I require my child/ren to be dropped off at school
Which Days Do You Require School Drop Off?
Monday
Tuesday
Wednesday
Thursday
Friday
School Pick Up
I require my child/ren to be picked up from school
Which Days Do You Require School Pick Up?
Monday
Tuesday
Wednesday
Thursday
Friday
Child 1 Details
Full Name:
(Required)
Date Of Birth
DD slash MM slash YYYY
School Name:
Year:
Room:
Address:
Phone:
Email
Child 2 Details
Full Name:
Date Of Birth
DD slash MM slash YYYY
School Name:
Year:
Room:
Address:
Phone:
Email
Child 3 Details
Full Name:
Date Of Birth
DD slash MM slash YYYY
School Name:
Year:
Room:
Address:
Phone:
Email
Child 4 Details
Full Name:
Date Of Birth
DD slash MM slash YYYY
School Name:
Year:
Room:
Address:
Phone:
Email
Phone:
Parent / Guardian Details
Parent / Guardian #1 Full Name:
Phone - Mobile:
Phone - Home:
Phone - Work:
Email:
Parent / Guardian #2 Full Name:
Phone - Mobile:
Phone - Home:
Phone - Work:
Email:
Emergency Contact
Emergency Contact Person (Must live within 30 minutes of the service)
I authorise my child to be dropped to the Emergency drop off address if I am unable to be contacted within 15 minutes of the specified home drop off time on the KaGo Schedule.
Emergency Contact Full Name:
Emergency Contact Address
Emergency Contact Ph - Mobile:
Emergency Contact Ph - Home:
Emergency Contact Ph - Work:
Emergency Contact Email:
Do your child/ren have any medical conditions and/or medications requirement and/or challenging behaviours?
Yes
No
[e.g. provide information regarding Medical Management Plan/Action Plans if required, or escapes seatbelt frequently]
Please Provide Details
Means Of Transportation
Acknowledgement
I understand and acknowledge that my child/ren will be transported in one of the KaGo Transport Services Pty Ltd fleet vehicles as per the list below. The exact vehicle will vary dependent on the route and number of children scheduled for transportation on a particular daily route. The number of children being transported will not exceed the maximum number of children being transported per vehicle detailed below.
PERTH METROPOLITAN TRANSPORT FLEET
Vehicle Type
Number of Seats
Maximum Number of Children per Vehicle
Number of Vehicle Type in Fleet
Kia Carnival
6
4
1
Toyota Tarago
6
4
1
Haval
4
2
3
LDV
11
9
10
LDV
12
10
11
LDV
10
8
5
SOUTHWEST TRANSPORT FLEET
Vehicle Type
Number of Seats
Maximum number of children per vehicle
Number of Vehicle Type in Fleet
Toyota HiAce
10
8
1
Toyota HiAce
12
10
7
Toyota HiAce
14
12
1
Mitsubishi Rosa
25
22
2
LDV D90
7
5
1
Monday To Friday Transit Timetable
Home pick up transit time:
7.15am–9.30am
Home drop off transit time:
3.30pm-5.30pm
BSC transit time:
8.15am-8.45am
ASC transit time:
3.00pm-3.45pm
Parent / Guardian Authorisation & Consent
Consent
I agree to the policy:
I hereby give my authorisation and consent for the Service to arrange regular transportation for my child/ren as detailed above for 12 months, effective from the date of this authorisation.
I authorise my child to be dropped to the Emergency drop off address if I am unable to be contacted within 15 minutes of the specified home drop off time on the KaGo Schedule.
In an emergency, I authorise the Service to seek necessary medical assistance from a medical practitioner or hospital, including transportation by ambulance if required and contact the child’s emergency contact if I cannot be reached immediately. I further warrant and acknowledge that;
The Western Australian Education and Care National Regulations 2012- Regulation 102D requires a transport risk assessment to be conducted before the transportation of my child.
Regulation 102D requires our service to receive parent/guardian written authorisation before the transportation of my child.
A risk assessment is to identify and assess any risks that the transportation of a child may pose to the safety, health and wellbeing of the child, inclusive of but not limited to challenging behaviours and/or medical conditions. My child’s risk assessment includes the regular transport route and any available alternative routes that may be used in an emergency or to avoid traffic congestion. All risk assessments are available for all parents and guardians to sight via the OWNA App. Policies and procedures for transporting children are also available to view via the OWNA App.
Requirements under the Western Australian Law for seat belts or safety restraints are adhered to and my child will be placed in a child car restraint that is suitable for their height and weight during transportation.
The number of children being transported will adhere to the maximum vehicle ratio of passengers – between 10-12 children per van and 20-22 children per bus (dependent on the type of vehicle).
The minimum supervising staff will consist of a bus driver and support person, and any additional support persons if identified as necessary in the individual transport risk assessments.
Regular transportation means, the transportation by the service, or arranged by the service of a child being educated and cared for by the service, where the circumstances relevant to a risk assessment are substantially the same for each occasion on which the child is transported.
An authorisation is only required once in a 12-month period for regular transportation.
Parent / Guardian Signature
(Required)
Date
(Required)
DD slash MM slash YYYY
