HARTLEY WINTNEY COMMUNITY BUS - Individual Registration Form 2013

You MUST register to use the Hartley Wintney Community Bus before you use the service. Once registered you will recieve a membership card which must be presented to the driver when using any of the timetabled or the door to door services. Please complete this form and submit, or atlernately print the form and return to the Administrator at: Hartley Wintney Community Bus. Parish Office, Appleton Hall, West Green Road, Hartley Wintney, Hampshire, RG27 8RE.

Please use block capitals.

Emergency Contact Details (For those under 16 or using the Door to Door services ONLY)

For DOOR TO DOOR SERVICES ONLY Please advise if you have any preferred destination, day or time to travel and we will try to accomodate you where possible.

Please note: Your email address may be used to provide occasional service and timetable updates. Your mobile telephone number may be used to provide notifications in the event of a disruption to the service. These details will not be passed on to any third party or used for any other purpose.

Terms and Conditions of Service

I confirm that:

All the information I have supplied is accurate;

I will inform Hartley Wintney Parish Council of any changes in my circumstances which may affect my eligibility to use the community transport service.

I live and/or work in Hartley Wintney or the adjoining parishes and confirm that my public transport needs are not met other than by virtue of the services provided by Hartley Wintney Parish Council Community Bus Service .

I consent to Hartley Wintney Parish Council sharing the information I provide with Hampshire County Council as the major funder of these services.

I accept that, when deemed necessary, a risk assessment relating to my safety when travelling will be carried out.

I understand that there will be a charge for using the Community Bus and agree to pay the appropriate fare. Payment may be made on the vehicle at the commencement of the journey or in advance.

I understand that the Community Transport Scheme is operated under a section 19 permit and as such I can only use the bus once I have registered with the Parish Council and am in reciept of a registration card. In order to verify this to the driver I will produce my card at the commencement of my journey. The driver will not allow passengers to travel is they have not registered to use the service.