Registration Form Continued

Please give details of anything else youthink we should know about you (e.g.your disability or special equipment etc.):

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Please send this form to:

Bath Dial-a-RideBath & North East Somerset Council

Windsor HouseWindsor Bridge Road

Bath BA2 3DT

I apply to register with Bath Dial-a-Rideand agree to abide by its conditions ofregistration and carriage.

Signature:. . . . . . . . . . . . . . . . . . . . . . . . .

Date: . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Prepared by Bath & North East Somerset Council’s Transport Services and published by Bath & North East Somerset Council’s Print Services, Dartmouth Avenue, Oldfield Park, Bath BA2 1AS

DP 3898 09/10 AR

BathDial-a-Ride

Telephone

01225 335019www.bathnes.gov.uk

Run for the community byBath & North EastSomerset Council

Transport ServicesPlease note:! We do our best to meet all requests.

However we do operate on a first come firstserved basis.

! We may ask you to alter your desiredjourney times slightly.

! We reserve the right to refuse or defer anapplication for registration, to ask foradditional information in support of anapplication or to cancel any existingregistration.

! All wheelchairs must be risk assessed by us before we can transport you.

Bath Dial-a-RideBath & North East Somerset Council

Windsor HouseWindsor Bridge Road

Bath BA2 3DT

01225 335019

This leaflet about the Bath Dial-a-Ride Servicecan be made available in a range of

community languages, large print, Braille, ontape, electronic and accessible formats from

Transport Services on 01225 335019.

Fully accessible minibus for those who cannot use conventional

public transport

Door-to-Door Service

How much will it cost?Within the Bath boundary, any return journeywill cost £4.00 and a single journey will cost£2.00. Concessionary bus pass holders areentitled to a 50% discount.

How do I book a journey?! Once your registration is confirmed,

telephone the booking line between 9.45 am and 12 noon on:

01225 335019! All bookings can be made up to 7 days in

advance.

When you book your journey...! Don’t forget to book your return journey

if needed.! Please be ready 10 minutes before

your journey time.

The information you have provided will be used to register youfor the Dial-a-Ride Service. We will not give information

about you to anyone else, or use information about you forother purposes, unless your consent has been given or the

law allows this.

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REGISTRATION FORMAll the information you give us is confidential.

Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Surname . . . . . . . . . . . . . . . . . . . . . . . . . . .

First names . . . . . . . . . . . . . . . . . . . . . . . . .

Address . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Postcode . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone . . . . . . . . . . . . . . . . . . . . . . . . . .

Bus Pass Number . . . . . . . . . . . . . . . . . . . .

Would you have any of the following when travelling?

Wheelchair . . . . . . . . . . . . . . . . . . . . . . .

Shopping trolley . . . . . . . . . . . . . . . . . . .

Walking aid . . . . . . . . . . . . . . . . . . . . . . .

Guide dog . . . . . . . . . . . . . . . . . . . . . . . .

Escort . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other (Please specify) . . . . . . . . . . . . . .

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Please give the name and telephonenumber of a friend or relative we cancontact in case of an emergency:

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What is Dial-a-Ride andwhat can I use it for?Dial-a-Ride is a door-to-door fully accessibleminibus service. You can use this service to:

!Go shopping!Visit key City destinations!Play an active part in community life

When does the serviceoperate?!There are two buses working constantly

within the service hours.!The service operates between

9.30 am - 2.30 pm from Monday to Fridayexcluding Bank Holidays.

Am I eligible?Any resident of Bath who cannot useconventional public transport is eligible toregister for this service. If you are unsurewhether you are eligible please contact theoffice between 9.45 am and 12 noon, on01225 335019.

How do I register?To register with the service complete theregistration form and return it to the Dial-a-Ride office at the address on the back.

Where can I go?The Dial-a-Ride service can be used forjourneys within Bath City boundaries, asshown in the map.

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