Adult Volunteer Authorization & Registration for Harvest Sunday - Driver

Medical Insurance Information in case of emergency

Driver Information

Vehicle that will be used

Please note that the minimal, acceptable liability limit for privately-owned vehicles is $100,000/$300,000.

Please be aware when using a personal vehicle, your insurance is primary. There is a policy that would offer additional liability protection should a claim exceed the limits of your policy.

Driving History

Have you had any of the following citations or convictions in the past THREE years:

Authorizations

Protecting God's Children Class Certification

If you have not had a background check performed within the past 5 years here at Maternity, you may be asked to complete a new one. We will notify you if that needs to be done.

Important! Don't forget to click on "Submit" below