BSM Transportation Form

Please note, Resurgence and Immersion is adhering to the CDC guidelines concerning COVID protocol. Students and Facilitators are required to complete health screenings and temperature checks during pick up. At the Youth Center, proper PPE and social distancing will be strongly enforced.

Name of Parent/Guardian(Required)
Which program(s) are you a part of?(Required)
Student's Name
Address
Which days do you require transportation?(Required)