RCC Vehicle Request/Use Form
The following guidelines apply for all who would use a church van.
1. The driver of the van must be at least 21 years old.
2. The driver must not have had a moving violation or chargeable accident within the past 3 years.
3. This van is insured for church use only. Any outside organization or private use is prohibited.
4. All reservations must be made through the church office.
5. When you use a van, upon return you are responsible to clean it and replenish any gasoline used.
6. State law and the policy of Riverside Community Church is that all employees and passengers
must wear a seatbelt at all times in vehicles in motion.
7. In case of an accident, a list of passengers with phone numbers, and a detailed description of the accident must be left in the church office or deposited in the mail slot before departing (Clipboard with blank forms is available in the van).
8. If you must remove one or more seats for your travel, they must be stored in RCC storage garage and returned to the van after you return.
9. At ALL times the posted speed limit must be observed, never place any cargo on the roof, and never tow any trailer without prior permission from the Business Administrator.
10. Vehicle usage log in the van must be completed along with a trouble report should you have a problem.
11. PA state law prohibits texting by the driver while the vehicle is in motion.
12. Which van are you requesting (check one or both) the Ford is for passengers only:
 The Ford van accommodates a maximum of 15, no towing or roof racks are permitted.
 The Chevy van accommodates a maximum of 15, no towing or roof racks are permitted.
Email address
Today's Date
MM
/
DD
/
YYYY
Department Making Request
Your answer
Type of Event
Your answer
Destination
Your answer
Will Pick Up
MM
/
DD
/
YYYY
Time
:
Will Return
MM
/
DD
/
YYYY
Time
:
Van Requested
Driver List (Must be at least 21 and supply a copy of current Driver's License)
*I have read the guidelines and agree to abide by them. Please list all drivers.
Your answer
The following guidelines apply for all who would drive the church van.
The following guidelines apply for all who would use a church van.
1. The driver of the van must be at least 21 years old.
2. The driver must not have had a moving violation or chargeable accident within the past 3 years.
3. This van is insured for church use only. Any outside organization or private use is prohibited.
4. All reservations must be made through the church office.
5. When you use a van, upon return you are responsible to clean it and replenish any gasoline used.
6. State law and the policy of Riverside Community Church is that all employees and passengers must wear a seatbelt at all times in vehicles in motion.
7. In case of an accident, a list of passengers with phone numbers, and a detailed description of the accident must be left in the church office or deposited in the mail slot before departing (Clipboard with blank forms is available in the van).
8. If you must remove one or more seats for your travel, they must be stored in RCC storage garage and returned to the van after you return.
9. At ALL times the posted speed limit must be observed, never place any cargo on the roof, and never tow any trailer without prior permission from the Business Administrator.
10. Vehicle usage log in the van must be completed along with a trouble report should you have a problem.
11. PA state law prohibits texting by the driver while the vehicle is in motion.
12. Which van are you requesting (check one or both) the Ford is for passengers only. The Ford van accommodates a maximum of 15, no towing or roof racks are permitted. The Chevy van accommodates a maximum of 15, no towing or roof racks are permitted.
13. Please submit a copy of all drivers current licenses to the church office.
Please view this video that describes safe use for 15 passenger vans. It is only 11 minutes in length: http://tinyurl.com/15-Passenger-Vans
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms