If driver is a parent of student(s) attending field trip/activity, List name(s) of student(s)
THE SCHOOL DISTRICT OF PALM BEACH COUNTY
Volunteer Driver Information
This form is to be completed by the volunteer/parent before the described event or activity. The completed and signed form
must be given to a school official along with a copy of your current insurance card, signed for approval, and filed with the
school. Parents/volunteers may not be able to know the final list or names of students who will be riding in their car until the
day of the trip.
PROOF OF INSURANCE AND DRIVER'S LICENSE: As a volunteer driver I am providing the above named school with
proof of current automobile insurance and will, if requested, provide proof to the parents/guardians of the students traveling in
the vehicle. I understand that the School Board does not provide insurance or any protection for damage to vehicles operated
by volunteers. I have been informed that based on current Florida law, the School Board is not responsible for the negligence
of volunteer drivers. To my knowledge, my vehicle has no unsafe conditions and is in good repair. I have also shown the
school a copy of my current driver's license.
Thank you for volunteering to be a driver on a school district related field trip(s) or activity. The information requested by this
form is required from each of our drivers. This is for your protection and the safety of the children.
School Name
Date(s) of Trip
Destination(s)(be specific)
Name of Driver
Make of Car Color of Car
Tag Number Tag Expiration Date
Driver's License State
Number of Passenger Seat Belts in Vehicle
Driver's License Expiration Date
Vehicle Holds Maximum Number of Passengers
Tag State
Signature of Driver/Parent
Date
PBSD 2362 (Rev. 7/17/2018) FL § 324.021 SBP 2.40 ORIGINAL - School COPY - Volunteer COPY - Parent/Guardian upon request
Note: The school must retain this form for the period of time required by the District's records retention schedule.
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PRINT OR TYPE
Teacher: Grade Level
Time of Departure Time of Return
Note that volunteer drivers are required to carry minimum insurance requirements as specified in Florida Statutes §§ 324.021
($10,000/20,000) and 627.736 (PIP), and volunteers are to be cleared through RAPTOR and complete the School Volunteer
(VIPS) application (PBSD 0887) online if not already done so this school year.
Year of Car
Number of car seats available (if applicable)
Signature of School Official Date
