Ystwyth Community Transport Booking Form

Section 1

Booking Organisation - …………………………………….

Contact Name - ……………………………….

Address - …………………………………………………………………………….. Postcode - …………………

Telephone - ………………………………… Mobile - ………………………………..

Email - ……………………………………………………………………………………………………………………

Name and Address for Invoice (If Different from above)

Name – ………………………………………..

Address - …………………………………………………………………………….. Postcode - …………………

Section 2

Date Mini Bus RequiredFrom - ……/……/……To - ……/……/……

Number of Minibuses -………………….Wheelchair Access Required – Yes/No

Driver Required – Yes/No

Number of passengers (please provide an estimate is not yet confirmed, Max 16) - ……………..

Please Complete the Next section if you require a Volunteer Driver, if not move the Section 4

Section 3

Full Address of First Pickup - ………………………………………………….. Postcode - …………………

Time of First Pickup(24hr Clock) - …..:……

Full Address of Destination – ………………………………………………….. Postcode - …………………

Arrival TimeRequired (24hr Clock) - …..:……

Return Required Yes/No Departure Time from venue - (24hr Clock) - …..:……

Please Complete below if there are additional locations the bus needs to collect passengers from (if a full list is not available, this need to be made available at least 3 working days before departure date)

Section 4

Please Complete if you are providing your own driver

Collection Time - Return Time -

Section 5

Additional Information:

Section 6 - Conditions of hire

  1. Groups of Organisations wishing to hire minibuses must be affiliated to or be a partner of Ystwyth Community Transport.
  2. Only drivers who have beenMiDASassessed, have a D1 category licence and registered with Ystwyth Community Transport drive the minibuses. Failure to comply with this rulingwill invalidate the insurance policy.Drivers can register with Ystwyth Community Transport by providing their driving licence (both parts), MiDAS certificate and have familiarisation with our minibuses before the day of travel.
  3. Provisional bookings or enquiries made by telephone or email not using this form cannot be considered a firm booking.
  4. You booking will be reviewed within 2 working days and an email confirmation will be sent out.
  5. If Ystwyth Community Transport are providing a Driver a list of passenger names and addresses must be supplied to Ystwyth Community Transport at least three working days before the date of travel (this is to satisfy insurance requirements). Failure to provide details within the allotted time may result in the cancellation of the booking.
  6. The hirer is responsible for ensuring that individual passenger risk assessments are completed.
  7. It is the responsibility of the hirer to ensure that risk assessments for individual passengers seated in wheelchairs are carried out. This should include consideration of the following: make and model, whether the wheelchair has been crash tested, whether the wheelchair has been modified and finally, the weight of the wheelchair.
  8. If you are supplying your own driver the hirer is responsible for collecting and returning minibus keysYstwyth Community Transport.
  9. Ystwyth Community Transport will endeavour to fulfil the booking but no responsibility can be accepted by Ystwyth Transport, its agents, servants or employees, should the minibus not be available through circumstances beyond our control.
  10. Cancellations must be made giving more than 24 hours notice. Failure to adhere to this directive may result in a £10 cancellation fee. The hirer is responsible for any charges related to parking the vehicle, including fines or penalties received due to parking violations.
  11. If you are providing your own driver, vehicles must be left in a clean and tidy condition ready for the next user. This includes basic cleaning of both the outside and inside of the vehicle, including removing rubbish. If a vehicle is left untidy, it may be subject to an additional £25 cleaning charge. General road grime is acceptable.
  12. A NO SMOKING policy applies to all vehicles failure to adhere to this will result in a £150 charge.
  13. An inventory is completed before every hire, any missing items will be charged for along with an £10 administration for each item.
  14. All passengers must wear a seatbelt in the minibus at all times unless they are exempt. Exemption should be confirmed by a doctor’s certificate,this should be carried at all times by the passenger for inspection as required by the driver or any legal authorities.
  15. Drivers must carry their licence with them at all times whilst on hire.
  16. Should the vehicle be involved in an accident or sustain damage, it is the hirers responsibility to inform Ystwyth Community Transport as soon as practically possible.
  17. If providing your own driver, they must complete a Journey Record Sheet for the period of the hire and left in the vehicle on its return.
  18. The vehicles hire check list must be signed before.
  19. Minibus’s must where reasonably possible be returned with a full tank of fuel (Fuel cards are provided with instructions for their use).

I am the responsible person and have completed this form to the best of my knowledge on behalf of the organisation in Section 1and agree to the condition of hire above.

Name:Signature : (Can be electronic)

Ystwyth Community Transport, 2/3 Lisburne Offices, Pontrhydygroes, SY25 6DQ

Tel:01974 282409. Email:

……………………………………..……Below For Office Use Only…….……………………..……………

Bus Registration - Volunteer Name -

Lock Box Code - Diary Updated –

Confirmation emailed - All details updated and confirmed by -