Transportation Contract Please enable JavaScript in your browser to complete this form.We provide pick-up and drop-off bus service at selected centralized locations only.Parent Name *FirstLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeTransportation FeesRound Trip One Way$2,850 $2,500 (First Child)$1,725 $1,550 (Each Additional Child)Oldest Child's Name *FirstLastTransportation service for oldest child *Round Trip- $2,850One Way- $2,500Do you have a second child who will be riding the bus? *YesNoSecond Oldest Child's Name *FirstLastTransportation service for second oldest child *Round Trip- $1,725One Way- $1,550Do you have a third child who will be riding the bus? *YesNoThird Oldest Child's Name *FirstLastTransportation service for third oldest child *Round Trip- $1,725One Way- $1,550Do you have a fourth child who will be riding the bus? *YesNoFourth Oldest Child's Name *FirstLastTransportation service for fourth oldest child *Round Trip- $1,725One Way- $1,550I/we, the undersigned, desire to arrange for transportation for the above-named child(ren) as indicated. We will be contacted as to pick up and drop off times, as well as the closest centralized location, and understand that while every effort is made to minimize the time spent on the bus, the farther distances necessarily require longer transportation time. A 10% deposit is due with this signed contract and the balance is due by September 1. *We (I) agree.I/we understand that misconduct/misbehavior by my/our child(ren) on the bus or at the bus stop is grounds for temporary or permanent dismissal from the Loudoun Country Day School transportation system at the discretion of the Headmaster. *We (I) agree. Full name of person completing this form *FirstLastPhone number of person completing this form *Email address of person completing this form *Deposit TotalThe total amount paid with this contract is 10% of the final cost of your requested transportation services. The balance is due September 1.$ 0.00Clicking the "Submit" button below will submit your transportation contract and take you to our electronic payment service.Submit & Proceed to Payment