Form

Legacy Care Rides LLC

2026–2027 School Transportation Registration Safe • Reliable • On Time
🎉 Legacy Special

Limited to the first 20 families!

✅ Lock in our exclusive $65/week rate for the entire 2026–2027 school year.

✅ $5 off each additional child in the same household.

⏳ Once the first 20 families have enrolled, the regular rate of $75/week applies.
Welcome to Legacy Care Rides LLC!

Thank you for choosing Legacy Care Rides for your child’s transportation needs.

Please complete this registration form. A seat is not reserved until your registration is submitted and the $50 registration deposit has been received.

Availability is limited and routes are filled on a first-come, first-served basis.
Parent/Guardian Full Name

First NameLast Name
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Parent/Guardian Full Name

First NameLast Name
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Full Name

First NameLast Name
Student Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Grade
School Name
Morning Pickup Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
After School Drop Off Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Transportation Needed
Special Pickup/Drop-off Instructions
Emergency Contact #1 Full Name

First NameLast Name
Relationship to Student
Example: Mother, Father, Grandparent, Aunt, Family Friend
Emergency Contact #1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact #2 Full Name (Optional)

First NameLast Name
Relationship to Student
Emergency Contact #2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical Information

Please provide any important medical information that will help us safely transport your child.
Does your child have any allergies?
If yes, please describe the allergies.
Medical Conditions (Optional)
Current Medications (Optional)
Special Needs or Transportation Instructions (Optional)
Example: Autism, ADHD, Uses inhaler, Carries EpiPen
Authorized Pick-Up / Drop-off Contact

If someone other than the parent or legal guardian may regularly receive your child, please provide their name, relationship, and phone number below.
Authorized Contact Information
Special Transportation Requests

Please let us know if your child has any special transportation or scheduling needs.
Please describe any special transportation requests.
Examples: Tuesdays & Thursdays only, Alternating weeks
Tuition & Registration
Weekly Tuition

🚐 Round Trip (Monday–Friday): $75/week

🌅 Morning Only: $45/week

🌇 Afternoon Only: $45/week

Payment Policy
- Weekly transportation fees are due in advance every Friday for the following week of service.
- Payments not received by 11:59 PM on Friday may result in a $15 late fee.
- If payment is not received by 6:00 AM on Monday, transportation services may be temporarily suspended until the account is brought current.
- Students with an outstanding balance may not be transported until payment has been received.
- Legacy Care Rides reserves the right to terminate transportation services for accounts with repeated late or missed payments.
- Families experiencing financial hardship should contact Legacy Care Rides before the payment due date to discuss possible arrangements.
Registration Deposit

A $50 Registration Deposit is required to reserve your child’s seat.

The deposit:
- Reserves your child’s seat
- Is non-refundable if the reservation is canceled after route assignment
Parent Agreement
Do you give Legacy Care Rides LLC permission to use photos of your child for promotional purposes?
By signing below, I acknowledge that I have read and agree to the Legacy Care Rides LLC Transportation Policies and understand that registration does not guarantee placement until route availability is confirmed.
Parent/Guardian Signature
Today’s Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Payment Summary

💳 $50 Registration Deposit (Required to reserve a seat)
🎉 Legacy Special: $65/week (Available to the first 20 families)
👨‍👩‍👧‍👦 $5 OFF each additional child from the same household
📈 Regular Weekly Rate: $75/week (After the first 20 families enroll)

📍Your weekly transportation rate will be confirmed before recurring payments begin.
🎉 Referral Program

Refer a new family to Legacy Care Rides!

When they enroll, pay their registration deposit, and complete their first week of paid service:

💜 You’ll receive a $25 account credit.

🎁 They’ll receive $10 OFF their first week of service.

✨ Unlimited referrals! The more families you refer, the more you save.

📍Referral rewards are applied after the referred family’s first week of paid service.
Were you referred by a current Legacy Care Rides family?
Who referred you?

Registration Deposit

Required to reserve your child's seat. This deposit is non-refundable after route assignment and will be applied according to the Registration Agreement.

$50.00

Total

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

ACH Bank Transfer

Should be Empty:

Legacy Care Rides LLC

Medical Information

Authorized Pick-Up / Drop-off Contact

Special Transportation Requests

Tuition & Registration

Registration Deposit*

Payment Methods

Registration Deposit