Authorised Driver Form

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Authorised Driver Form

To be completed by all adults driving children at Balcombe School

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* Indicates required question

Name *

Your answer

Phone number *

Your answer

Licence Plate *

Your answer

Licence Number *

Your answer

I confirm that I am fully insured with appropriate cover to transport children *

Yes

No

Insurer *

Your answer

Policy Number *

Your answer

Insurance Expiry Date *

MM

/

DD

/

YYYY

MOT expiry date (if applicable)

MM

/

DD

/

YYYY

Name: I confirm that the above information is correct and there is no impediment bodily or legal to disqualify me from driving children. *

Your answer

Date completed *

MM

/

DD

/

YYYY

Option 1

Clear selection

Option 1

Clear selection

Submit

Clear form

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