3898 Bath Dial-a-Ride:Dial a ride 05 01/04/2011 10:01 Page 1
Registration Form Continued
How much will it cost?
Please give details of anything else you think we should know about you (e.g. your disability or special equipment etc.):
Within the Bath boundary, any return journey will cost £4.00 and a single journey will cost £2.00. Concessionary bus pass holders are entitled to a 50% discount.
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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.
................................. Please send this form to: Bath Dial-a-Ride Bath & North East Somerset Council Windsor House Windsor Bridge Road Bath BA2 3DT I apply to register with Bath Dial-a-Ride and agree to abide by its conditions of registration and carriage. Signature:. . . . . . . . . . . . . . . . . . . . . . . . .
When you book your journey... ! Don’t forget to book your return journey if needed. ! Please be ready 10 minutes before your journey time.
Run for the community by Bath & North East Somerset Council Transport Services Please note: ! We do our best to meet all requests. However we do operate on a first come first served basis. ! We may ask you to alter your desired journey times slightly. ! We reserve the right to refuse or defer an application for registration, to ask for additional information in support of an application or to cancel any existing registration. ! All wheelchairs must be risk assessed by us before we can transport you.
Bath Dial-a-Ride Door-to-Door Service
Bath Dial-a-Ride Bath & North East Somerset Council Windsor House Windsor Bridge Road Bath BA2 3DT
01225 335019 The information you have provided will be used to register you for the Dial-a-Ride Service. We will not give information about you to anyone else, or use information about you for other purposes, unless your consent has been given or the law allows this.
This leaflet about the Bath Dial-a-Ride Service can be made available in a range of community languages, large print, Braille, on tape, electronic and accessible formats from Transport Services on 01225 335019.
Fully accessible minibus for those who cannot use conventional public transport Telephone
Date: . . . . . . . . . . . . . . . . . . . . . . . . . . . .
01225 335019 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
www.bathnes.gov.uk
3898 Bath Dial-a-Ride:Dial a ride 05 01/04/2011 10:01 Page 2
What is Dial-a-Ride and what can I use it for? Dial-a-Ride is a door-to-door fully accessible minibus service. You can use this service to:
Where can I go?
REGISTRATION FORM
The Dial-a-Ride service can be used for journeys within Bath City boundaries, as shown in the map.
All the information you give us is confidential. Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
! Go shopping ! Visit key City destinations ! Play an active part in community life
Surname . . . . . . . . . . . . . . . . . . . . . . . . . . .
When does the service operate?
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First names . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................................... Postcode . . . . . . . . . . . . . . . . . . . . . . . . . . .
! There are two buses working constantly
Telephone . . . . . . . . . . . . . . . . . . . . . . . . . .
within the service hours. ! The service operates between 9.30 am - 2.30 pm from Monday to Friday excluding Bank Holidays.
Bus Pass Number . . . . . . . . . . . . . . . . . . . .
Would you have any of the following when travelling?
Am I eligible?
Wheelchair . . . . . . . . . . . . . . . . . . . . . . .
Any resident of Bath who cannot use conventional public transport is eligible to register for this service. If you are unsure whether you are eligible please contact the office between 9.45 am and 12 noon, on
Shopping trolley . . . . . . . . . . . . . . . . . . . Walking aid . . . . . . . . . . . . . . . . . . . . . . . Guide dog . . . . . . . . . . . . . . . . . . . . . . . . Escort . . . . . . . . . . . . . . . . . . . . . . . . . . .
01225 335019.
To register with the service complete the registration form and return it to the Dial-aRide office at the address on the back.
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How do I register?
Other (Please specify) . . . . . . . . . . . . . . ................................ Please give the name and telephone number of a friend or relative we can contact in case of an emergency: ................................... ...................................