St Joseph's Kingswood eNewsletter

Students Travelling in Private Motor Vehicles Agreement Form

Dear employee / parent / legal guardian / volunteer,

Thank you for offering to transport children and young people in your car. Could you please sign and return this form as proof of your acceptance of the following conditions:

You hold a current driver’s licence
The car you will be driving is registered and roadworthy (enter registration expiry below)
All passengers must have a designated seat and be wearing an appropriate seat belt, restraint, harness appropriate for age, height and weight. Any passengers aged 7 years and under must not travel in the front seat of a vehicle.
Child restraints, safety harnesses and booster seats must comply with Australian/New Zealand Standard 1754:2013.
The car you will be driving is covered by the following insurances:
- Third Party Property
- Comprehensive
That neither the school nor CESA is liable for reimbursing any out-of-pocket expenses incurred as the result of an accident.

First Name *

Last Name *

Email *

Driver's License Number *

Car registration expiry *

Vehicle make and model *

Vehicle number plate *

Number of passengers *