Diocese of
Name Phone
I understand and agree to the following rules concerning the transport of minors:
All drivers must:
· Be at least 21 years old
· Have a current and valid driver license (issued within the
· Have completed and properly filed diocesan form AS-1, Application for Service
· Successfully completed Youth Protection 1 Seminar (schedule of sessions)
· Obey all applicable traffic laws
· Enforce a “non-smoking” policy inside the vehicle while transporting minors
· Abstain from the use of a cell phone or other communication device while operating the vehicle
· Abstain from alcohol or other substances which may impair judgment or the ability to safely operate the vehicle. Period of abstinence must
include at least six hours before driving through time of arrival at final destination
All vehicles must:
· Be currently registered with a state
· Have an appropriate seat and seatbelt for each passenger
· Be in good operating condition with all safety equipment functioning properly
· Have vehicle liability insurance in the minimum of $100,000 per person/$300,000 per occurrence
I have not been convicted of driving under the influence or reckless driving during the past five years.
I give permission to the Diocese of Birmingham to secure a report on my past driving record. I understand that my personal information may be transmitted to an outside company or agency to get the report.
Signature _________________________________ Date __________________________