EmailMe Form - CPA/CODCA/PPOS Ride Share Request

CPA/CODCA/PPOS Ride Share Request

Colorado Preparatory Academy, Pikes Peak Online School, & Destinations Career Academy will pay for transportation for families and/or students who need a ride for specific required events. This form must be filled out in order to secure a ride. It will also allow it to be billed to the school.

We have rideshare arrangements with 2 different companies.
Lyft - Ordered for students over age 18 riding alone or students of any age riding with an adult
HopSkipDrive - Ordered for students riding alone. Drivers are specially-certified and finger-printed with background checks.

To participate in a Rideshare (Lyft and/or HopSkipDrive) arrangement, parent(s) and/or legal guardian(s) are required to complete and submit this form prior to the start of a Rideshare arrangement.

Please list all students who require transportation below

First Name Last Name Age Grade

Student 1

Student 2 (if appllicable)

Student 3 (if applicable)

Student 4 (if applicable)
Name of Person Requesting Ride(Must be a Parent/Guardian) *
First Last
E-mail of Person Requesting Ride - This enables us to send you a copy of this form for your records *
Contact Phone Number - We will use this number to verify when a driver is on their way or arrived as well as any transportation updates or changes *
Type of Contact Permissible *
Phone Call
Text
Both Phone Call and Text
Emergency Contact Number
Address of Pick-Up *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Who will be taking the ride? *
Student(s) will ride alone
An adult (parent/legal guardian) will ride with the student(s)
An adult (parent/ legal guardian) and other siblings will ride with the student(s)
An adult other than the parent/legal guardian will ride with student(s) (& siblings, if needed)
Total Number of Passengers *
Name of adult riding with student (if applicable)
Names and ages of children, other than student(s), under age 18 taking ride (if applicable) - please be prepared to bring your own car accessory needs such as booster seats, special car seats, etc.
Type of Event *
Test
Blended Learning
School Event
Other
Date of Test/Event *
Time of Test/Event (we will notify you of pick-up time after the ride is ordered based on location and time of test) *
Location of Test/Event
Address of Drop-Off (If different from Pick-Up)

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
I/we, individually and on behalf of my/our child assume all risks and waive any liability of any nature whatsoever against CPA, CODCA, or PPOS, with respect to any and all actions, claims, or demands (including attorney’s fees) that may accrue or be made or be brought by the, said child(ren) on this form, or someone on behalf of said child, against CPA, CODCA, PPOS, which arise out of our in connection with my child’s participation in ANY Rideshare arrangement, whether such claim, demand or action is the result of the negligence of Rideshare participants or otherwise.
By digitally signing below, you acknowledge that all information in this form is correct and you commit to ensuring the ride is taken by the student. If a ride needs cancelled, the school must have a 24 hour notice if the student is riding alone and 8 hours notice if at least one adult is riding or the student is over age 18. If notice is not given and the ride is not taken for any reason, the family will be charged the cost of the ride and their account will be billed by the school. Cancellation notices and changes need to be given to Susan Wall at K12 - 720-621-6324 or tewall@k12.com. SUSAN WILL REACH OUT TO YOU THE DAY BEFORE THE RIDE TO LET YOU KNOW WHEN YOUR DRIVER IS EXPECTED TO SHOW AT YOUR PICK-UP LOCATION. *

	First Name	Last Name	Age	Grade
Student 1
Student 2 (if appllicable)
Student 3 (if applicable)
Student 4 (if applicable)