NEW!! Driver_Owner Info Form

Driver/Owner Information Form

This form shall be filled out by any guardian/parent transporting students in their vehicle. One form per person please.

ATTENTION: We will keep a copy of your valid Drivers License on file until it expires. At that time you must submit a new copy. For questions ask the Front Office.

We must have a valid EMAIL address to send you a link for a background check if you have not completed one or if yours is expired. Background checks last 5 years.

Driver Information Section:

I certify that as a driver of a private vehicle transporting students to a school sponsored function:

A. I am at least eighteen (18) years old and have been a fully licensed driver for a period of at least one (1) calendar year.

B. I currently possess a valid driver's license that does not have any legal restriction, limitation, or suspension associated or attached to it. I also certify that I have current registration on this vehicle.

C. I possess insurance coverage on the vehicle that I will be driving, including liability coverage in the amount of at least equal to the minimum required by the State of Michigan and TCCS ($500,000 liability coverage

D. I am not aware of any mechanical defect or problem with the vehicle that might make it unsafe for purposes of this trip.

E. I agree to transport no more than the number of persons for which the vehicle is designed for.

F. I will make sure that all passengers will ride properly belted and that those under the age of thirteen (13) will sit in the rear seats only.

G. I understand that I am in charge of this vehicle. I will see to it that no occupant consumes tobacco, alcoholic beverages, or illegal substances in or around this vehicle. I will see to it that no occupant possesses a weapon or firearm.

H. This is a school-sponsored field trip. By signing this form I agree to abide by TCCS Student/Parent Handbook expectations.

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I hereby certify that the information given on this form is true and correct to the best of my knowledge. I understand that as a volunteer/employee driver, I hold a valid driver's license and have the required insurance coverage in effect on any vehicle used to transport students, co-employees, service recipients and/or act on behalf of the school or related entities.

Signature of Driver*

First Name*

Last Name*

Date*

Date

Insurance Company Name*

Insurance Policy Number*

You must have AT LEAST $500,000 in liability coverage for this vehicle

**You are responsible for looking this up on the declarations page of your policy. We cannot look it up for you. **

I confirm that I have AT LEAST $500,000 in liability coverage for this vehicle.*

YesNo

Driver's License Number*

License Plate Number*

Make (ex. Ford)*

Model (ex. F150)*

Year*

I acknowledge that all volunteers (including drivers) are subject to background checks. I understand that / will be contacted via the email address below to submit my information electronically for the background check to be processed.

Email Address*