Authorised Driver Form
To be completed by all adults driving at Balcombe School
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Name *
Phone number *
Licence Plate *
I confirm that I am fully insured with appropriate cover to transport children *
Insurer *
Policy Number *
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 *
Date Completed *
MM
/
DD
/
YYYY
Submit
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