Bus Route Status:
Normal Service (All Buses Are On Schedule)
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Optional: To download the application, fill it
out and send it in, please click here to download.
Please fill out this form completely. Uncompleted forms will be
Fields marked with * are required.
If you have mobility difficulties that limit you from using the
fixed route accessible buses, you may be eligible to participate in
Coast RTA's Paratransit Program. Please complete all the
information below so that the Coast may assist you with your
I agree that I will pay the exact fare, if required, for each
trip. I agree to notify Coast's Paratransit office of any changes
in my staus which may affect my eligibility to use the service. I
also understand that failure to adhere to the policies and
procedures will be grounds for revoking my application and the
right to participate in the program. I understand and agree to hold
Coast RTA Waccamaw Regional Transportation Authority harmless
against all claims or liability for damages to any person,
property, or personal injury occuring as a result of my failure to
equip or maintain the safety measures of the adaptive equipment or
certified guide/service animal that I require for mobility. I have
read and fully understand the conditions for service outlined above
and agree to abide by them.
I hereby authorize the release of the certification information
and any additional information to Coast RTA Waccamaw Regional
Transportation Authority for the purposes of evaluating my
eligibility to participate in Coast RTA's Paratransit Program. I
further understand that any such information will be kept
This certified that this application was completed by me, and
that all entries on it and information in it are true and complete
to the best of my knowledge.
If you click submit, you are giving Coast RTA your electronic
signature, which is binding in a court of law.
Email address *
Mailing address *
Apartment / unit number
Zip code *
Physical address (if different from mailing address)
Home phone number *
Work phone number
Alternative phone number
Date of birth
* This is a printer friendly version of the original page, made to save you ink and paper.
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