UW Recreation- Club Driver Authorization

Driver Authorization
Primary Club*
Additional Club
(if applicable)
Name*

First NameLast Name
Cell Phone*
Email*
Club status:*

StudentFaculty/StaffVolunteer
Are you 18 years old or older?*
Date of Birth*

MonthDayYear
All drivers must be at least 18 years old to be an approved rec club driver. If you are under 18 please notify your club officers that you cannot be an approved driver.

Driving Information

The following questions ask for information that you are obligated to update should the status change. If there is any change to any of the answers you provide below, you are required to notify the Rec Clubs Office promptly before driving to/from any Rec Clubs event or activity. This means that you must tell us before driving other students in your car for rec clubs travel, if, for example:
- Your licenses is revoked, suspended, or expired
- Your insurance expires
Do you have a valid driver's license?*

YesNo
Driver's License Issuing State*
Driver's License Number*
For this academic year, do you plan on driving rental vehicles or your personal vehicle for rec club trips?

RentalPersonalBoth
Vehicle Information
Insurance Provider*
Insurance Policy Number*
Insurance Policy Expiration Date*

MonthDayYear
Date
Vehicle Make*
Vehicle Model*
Vehicle Year*
To your knowledge, is your personal vehicle in safe condition to drive?*

YesNo

Vehicle Use

1. All drivers must adhere to all state and local laws when operating a vehicle for university business.

2. Drivers are responsible for conducting a vehicle inspection prior to the departure of each club sport activity.

3. The use of handheld mobile devices is prohibited while driving, including when the vehicle is stopped within traffic (such as stop lights). Drivers must pull over completely in order to use handheld devices.

4. Drivers and passengers must always wear seatbelts while vehicles are in motion.

5. Passengers may not sit or stand on the outside of a vehicle while it is in motion.

6. Vehicular accidents involving any injuries or property damage must be reported immediately.

7. Driving and parking violations are the responsibility of the driver and will not be paid by the Rec Clubs Office.

8. Drivers may not operate any vehicle under the influence of alcohol, other substance or circumstance that may impair ones driving ability.
Vehicle Accident Reporting

1) Rec Clubs are responsible for reporting a vehicle accident to the Rec Clubs Office. An Incident Report should be completed within 24 hours if possible following the accident.
Acknowledgement

1) By providing my electronic signature below, I certify that I am 18 years or older, the information provided is accurate, and I agree to the following Vehicle Use and Vehicle Accident Reporting policies.
Name*
Signature*
Should be Empty:

Driver Authorization