STUDENT DRIVER Authorization

AUTHORIZATION FOR STUDENT DRIVER
Student Name*

First NameLast Name
Grade*
Driver's License Number*
License Expiration Date*

MonthDayYear
Date
Upload a picture of your valid Texas Driver's License*

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Vehicle Make/Model*
Vehicle Color*
License Plate Number*
2nd Vehicle Make/Model
2nd Vehicle Color
2nd License Plate Number
Insurance Company*
Policy Number*
Upload Proof of Insurance*

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Student Driver Agreement

Students must adhere to the rules for safe and lawful driving. Reckless or unsafe driving issues will be documented and may be cause for termination of driving privileges on campus.
- Student parking is located in the front parking lot of the school.
- Guest parking spaces or any other non-designated areas may not be used by student drivers.
- The speed limit on campus is 10 mph.
- No loitering in, on, or around vehicles between classes.
- Students are not allowed to drive other students to or from school-related activities without written parent permission.
- All reckless or unsafe driving incidents will be documented and may result in disciplinary action, including loss of privileges.
As a student authorized to drive on the Summit Christian Academy campus, I agree to abide by the rules stated above. I understand that permission to drive on campus may be revoked, with just cause, at the sole discretion of school administration
Student Agreement & Signature*

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Date*

MonthDayYear
Date
Parent Acknowledgment

I hereby give my child permission to drive the vehicle designated above to and from Summit Christian Academy. I have read and agree to the rules stated above and understand that any violation of these rules may result in the temporary or permanent loss of driving privileges on campus.
Parent/Guardian Name*

First NameLast Name
Parent/Guardain Phone*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Date*

MonthDayYear
Date
Signature*

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AUTHORIZATION FOR STUDENT DRIVER