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Brant Transit Caregiver Account Access and Consent

Administering Authority: The Corporation of the County of Brant

Transit Provider: River North Transit LLC (O/A Via Transportation)

This Agreement serves as a formal, written declaration of consent from the Rider (or their authorized Legal Guardian/Power of Attorney) to link a designated Caregiver's transit account with the Rider's account. This linking grants the Caregiver the ability to track, book, and modify the Rider’s scheduled trips through the designated Caregiver web application.

Rider Information (Care-Recipient)

Full Legal Name:

Phone Number associated with the Rider Account:

Rider ID:

II. Caregiver Information

Please indicate the Caregiver you would like to assign to the Rider:

Individual Caregiver - The individual listed below will be the only person authorized to be linked as the Caregiver and granted access under this Agreement.

Organization Caregiver - The organization listed below, including its authorized staff, will be linked as the Caregiver and granted access under this Agreement.

Rider ID (To be filled in by Brant Transit):

III. Scope of Caregiver Access

By signing below, the Rider (or their legal representative) grants the Caregiver, as identified in Section II, the following access to the Rider's trip information and account data, accessible via the Caregiver application:

Real-Time Trip Tracking: View the real-time location and status of currently active and upcoming scheduled rides.
Ride Detail Access: View details of upcoming, active, and recent rides, including pickup/drop-off times and locations.
Ride Management: The ability to book, cancel, or modify future ride reservations on behalf of the Rider.

IV. Rider Consent (If Applicable, Otherwise See Section V)

I, the Rider, certify that I am mentally competent and have the full legal capacity to enter into this agreement. I understand the access rights granted to the Caregiver listed above, and I freely and voluntarily consent to linking their account to mine to provide them with the tracking and ride management access described in Section III.

Rider Signature:

Clear

Today's Date:

V. Legal Guardian / Power of Attorney (POA) Consent (If Applicable)

This section must be completed if the Rider is unable to provide consent in Section IV.

I certify that I am the legally authorized representative for the Rider listed in Section I. I have reviewed the Scope of Caregiver Access (Section III) and, pursuant to my legal authority, I consent to the linking of the Caregiver’s account to the Rider's account for the purposes of tracking and managing their Brant Transit rides.

Legal Status (Check One):

Legal Guardian / Custodian

Power of Attorney (POA) - Personal Care

Power of Attorney (POA) - Property

Other

Legal Representative Signature

Clear

Name and Title:

Today's Date:

VI. Data Acknowledgement and Release

By signing this Agreement, all parties acknowledge that:

This signed document will be administered by the The Corporation of the County of Brant (“County”) and a copy will be securely shared with River North Transit LLC (O/A Via Transportation) solely for the purpose of configuring the Caregiver Account access within their transit management system.
The Caregiver's access will be configured and maintained at the discretion of the County and can be revoked at any time by the County or upon written request from the Rider or their Legal Representative.
All data accessed remains subject to the privacy policies of the County and River North Transit LLC (O/A Via Transportation).