Bus Registration Form

- 2025- 2026 Bus Registration Form
  
  We are beginning the process of planning for the 2025-2026 school year. We need your assistance in making our routes as accurate as possible. In order to confirm your child’s seat on a bus for 2025-2026, we ask that you complete the form below. There is a $50 per student busing ridership fee. If your child previously rode the bus, they will not be automatically put on a route for the next school year. Please fill out the form completely. Students are only routed when this form is filled out and the ridership fee is paid. Students who live outside of the Iowa City Community School District will NOT be routed.
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  Parent/Guardian Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  I confirm that we live within the Iowa City Community School District. Please do not continue if you reside outside of the ICCSD. REQUIRED Yes Please fill out this field.
  
  We live in the Iowa City School District and at least two (2) miles (grades K-8) or three (3) miles (grades 9-12) from Regina. REQUIRED Yes Please fill out this field.
  
  How many students do you have eligible to ride the bus? REQUIRED 1 2 3 4 5 Please fill out this field.
  
  Number of Students Please fill out this field.
  
  Student 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade for 2025-2026 REQUIRED Please fill out this field.
  
  House Number and Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Emergency Contact #1 - Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #1 - Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #2 - Name Please enter valid data.
  
  Emergency Contact #2 - Phone Number Please enter valid data.
  
  Student 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade for 2025-2026 REQUIRED Please fill out this field.
  
  House Number and Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Emergency Contact #1 - Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #1 - Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #2 - Name Please enter valid data.
  
  Emergency Contact #2 - Phone Number Please enter valid data.
  
  Student 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade for 2025-2026 REQUIRED Please fill out this field.
  
  House Number and Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Emergency Contact #1 - Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #1 - Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #2 - Name Please enter valid data.
  
  Emergency Contact #2 - Phone Number Please enter valid data.
  
  Student 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade for 2025-2026 REQUIRED Please fill out this field.
  
  House Number and Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Emergency Contact #1 - Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #1 - Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #2 - Name Please enter valid data.
  
  Emergency Contact #2 - Phone Number Please enter valid data.
  
  Student 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade for 2025-2026 REQUIRED Please fill out this field.
  
  House Number and Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Emergency Contact #1 - Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #1 - Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact #2 - Name Please enter valid data.
  
  Emergency Contact #2 - Phone Number Please enter valid data.
  
  If your student(s) will be utilizing more than one stop, please include any additional addresses and days of the week the different addresses will be used. Please specify if they need only AM pick up or PM drop off.
  
  Bus Registration REQUIRED Please fill out this field.
  
  Credit Card Processing Fee REQUIRED 3.1% Please fill out this field.
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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