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Authorised Driver Form
To be completed by all adults driving at Balcombe School
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* Indicates required question
Name
*
Your answer
Phone number
*
Your answer
Licence Plate
*
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
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