Volunteer Driver Form
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1Volunteer Driver Form
School Name: Bearspaw Christian School
School Year: 2014/2015
Driver’s Name: ________________________________________
Phone Number: _______________________________
Driver’s Address: ______________________________________________________________________________________
Applications may be approved only when the driver possesses a valid, appropriate driver’s license and is able to respond No to
questions concerning convictions and suspensions over the last three years.
Driver’s License Number: _______________________ Class: ___________ Expiry Date: _____________________________
o
o
Has your driver’s license been suspended in the last three years?
Yes
No
If Yes, please provide date of reinstatement: _________________________________________________________________
Have you been convicted of an offence under the Highway Traffic Act, the Motor Vehicle Administration Act, or for any motor
o
o
vehicle-related offence under the Criminal Code of Canada during the last three years?
Yes
No
If Yes, please identify the offence(s) here: __________________________________________________________________
o
o
Were you found responsible/partly responsible for any motor vehicle accident(s) over the last three years?
Yes
No
Insurance Related Considerations:
1. The school requires that the vehicle owner maintain, at all times, insurance in an amount of not less than $1,000,000 in respect
of liability or injury or death of any students who are passengers in the vehicle the volunteer driver is operating.
2. In case of an insurance claim (i.e., third party damage and/or personal injury) the vehicle owner’s automobile liability insurance
applies before that of the school.
3. Additional automobile liability insurance protection is provided under the school board’s comprehensive general liability insurance
policy for authorized drivers transporting students in privately-owned vehicles on an approved school activity. This insurance is
only for an amount in excess of the limit of liability provided by the vehicle owner’s liability insurance policy.
4. Damage to any vehicle, including the owner’s, is the responsibility of the volunteer driver and not the school.
5. The owner of the vehicle is expected to inform his/her insurance agent of the intention to use the vehicle and to act as a
volunteer driver for school activities, and to enquire whether a passenger endorsement is required to do this. As this driving is
classified as occasional and volunteer, most insurers do not require that a passenger endorsement be added to the policy or that
additional premiums be paid.
Vehicle: _____________________________________________________________________________________________
Make
/
Model
/
Seating Capacity (Including Driver)
Owner’s Name: _______________________________________________________________________________________
Owner’s Address: ______________________________________________________________________________________
Owner’s Phone: _______________________________________________________________________________________
Insurance On Vehicle - Company: _______________________________________ Policy No.: _______________________
Insurance Agent: ____________________________ Liability Limit: $ ________
Copy of Pink Slip Attached Mandatory
COMMITMENTS
By submitting this application to become a volunteer driver for the Bearspaw Christian School.
1. I undertake to ensure that the vehicle used to transport students is in safe operating condition.
2. I agree to operate the automobile referred to herein in a safe manner, to abide by all applicable laws at all times while I am
transporting students, to limit the number of passengers to the number of useable seat belts, to require proper use of occupant
restraint systems (i.e., seatbelts, head restraints, airbags, seat position), and to comply with the directions of teachers or agents of
the Bearspaw Christian School.
3. I undertake to report to the school principal all accidents and any suspension of my license or change in my insurance status
which may occur after the date of this authorization while it remains in force (i.e., this school year).
4. I have advised my insurance company that I have applied to serve as a volunteer driver and inquired whether a passenger
endorsement is necessary.
5. I undertake to maintain, at all times, personal liability and indemnity insurance equal to or greater than the school minimal limit
noted above.
6. I accept the foregoing undertakings and certify that the information contained in this application is correct to the best of my
knowledge:
Signature of Driver: ____________________________________________________________________________________
Signature of Vehicle Owner: _________________________________________________________________________
Parent/Guardian (if driver is under 18 years of age): ______________________________________________________
.
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