Driver Info Sheet

This form is to allow drivers to drive and carpool minors.

Event
Date //
  •  
Destination
  •  
Driver
Name
  •  
DOB //
  •  
Address
  •  
Phone --
  •  
Social Security Number
  •  
Driver License Number
  •  
Expiration Date //
  •  
Vehicle
Name of Owner
  •  
Owners Address
  •  
Model
  •  
Vehicle Make
  •  
License Plate Number
  •  
Expiration Date  
  •  
Insurance Information
When using privately owned vehicles, the insurance coverage is the limit of the insurance policy covering that specific vehicle.
Insurance Company
  •  
Policy Number
  •  
Expiration Date  
  •  
Liability Limits of Policy
  •  
$100,000/$300,000
  •  
I certify that the information given on this form is true and correct to the best of my knowledge. I understand that as a volunteer driver, I must be 21 years of age or older, possess a valid driver's license, have the proper and current license and vehicle registration, and have the required insurance coverage in effect on any vehicle used to transport youth. I agree that while I am transporting minors to/from the above listed event, I will no, within six hours of the commencement of the event, nor during the course of the event drink any alcoholic beverage. I will follow and observe the Rules of the Road (including speed limits) as are applicable in the State of South Carolina, and in each city in which I will be transporting minors. I will take seriously my obligation to these minors in transporting them; and I will require each minor in my automobile to use the seat belt available to him/her. Within the past five years I have not been charged with or convicted of reckless driving or driving while intoxicated. I attest that I do not have any restrictions on my South Carolina Driver's License.
Signature
  •  
Date //
  •  
  •  
 
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