Pack 165 Event Driver and Vehicle Information Form | 2019
This is for the 2018-19 school year. You will only need to fill this information out once this year!
Driver Information
First Name *
First name of the adult that may drive to a scouting trip
Your answer
Last Name *
Last name of the adult that may drive to a scouting trip
Your answer
Driver's license number for driver(s) *
Your answer
Cell phone number *
Your answer
Email Address *
Your answer
Vehicle Information
Make of vehicle *
Your answer
Model of vehicle *
Your answer
Year of vehicle *
Your answer
Number of passengers vehicle holds (including driver) *
Your answer
Do all passenger seats have seatbelts? *
Vehicle License Plate # *
Your answer
Insurance Information
All vehicles MUST be covered by a liability and property damage insurance policy. The amount of this coverage must meet or exceed the insurance requirement of the state in which the vehicle is licensed and comply with or exceed the requirements of the country of destination for travel outside the United States. It is recommended, however, that coverage limits are at least $100,000 combined single limit. Any vehicle designed to carry 10 or more passengers is required to have limits of $500,000 combined single limit. In the case of rented vehicles, the requirement of coverage limits can be met by combining the limits of personal coverage carried by the driver with coverage carried by the owner of the rented vehicle.
Public Liability Coverage - Each Person $ *
Your answer
Public Liability Coverage - Each Accident $ *
Your answer
Property Damage Liability - Each Accident $ *
Your answer
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