Two Rock Un SD | E 3541.1 Business and Noninstructional Operations
Transportation For School-Related Trips
SCHOOL DRIVER REGISTRATION FORM
Driver (circle one): Employee Parent/Guardian Volunteer
Name: Date of Birth:
Address: Driver's License No.:
Telephone No.: ( ) Expiration Date:
VEHICLE INFORMATION
Name of Owner: Year:
Address: Make:
License Plate No.:
Registration Expiration: Seating Capacity:
INSURANCE INFORMATION
Insurance Company: Policy No.:
Telephone No.: Expiration Date:
Liability Limits of Policy:
DRIVER STATEMENT
I certify that I have not been convicted of reckless driving or driving under the influence of drugs or alcohol within the past five years and that the information given above is true and correct. I understand that if an accident occurs, my insurance coverage shall bear primary responsibility for any losses or claims for damages.
I certify that I will ensure that all children will be restrained using the appropriate passenger restraint systems.
Name: Date:
Exhibit TWO ROCK UNION ELEMENTARY SCHOOL DISTRICT
version: June 11, 2002 Petaluma, California
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Exhibit 2
3541.1
TRANSPORTATION FOR SCHOOL-RELATED TRIPS
GUIDELINES FOR USE OF PRIVATE VEHICLES FOR
DISTRICT FIELD TRIPS
All drivers need to complete our driver registration form. The completed form needs to be reviewed and approved by the Superintendent/Principal prior to the driver being approved to drive on the field trip.
The driver of each vehicle must:
1. Have a valid driver's license and registration.
2. Have current liability insurance at or above $100,000/$300,000.
3. Affirm that they have not been convicted of reckless driving or driving under the influence of drugs or alcohol within the last five years.
4. Check the safety of the vehicle's tires, brakes, lights, horn, seat belts, suspension, engine, etc.
5. Carry only the number of passengers who can safely sit in the passenger compartment with seat belts, away from front air bags.
In case of emergency, keep at the children together and call 762-6617 or 911.
Exhibit TWO ROCK UNION ELEMENTARY SCHOOL DISTRICT
version: June 11, 2002 Petaluma, California