Authorization to Drive Company Vehicle

							                  PARENT AUTHORIZATION FORM TO DRIVE
                             SAN MARINO UNIFIED SCHOOL DISTRICT
                                              2002 — 2003
                             For Parents to Drive Elementary School Students
                                       to School Sponsored Events

Thank you for volunteering to drive students in your private vehicle to school sponsored events
    From September 2002 to June 2003
The District requires that we notify you of the following:

1. Each driver of a private vehicle must have a valid California Driver’s License.

2. Each vehicle shall carry and show proof of the following insurance coverage:
      Liability: $100,000 each person! $300,000 each occurrence
      Property Damage: $50,000 each occurrence
      Drivers must attach to this form a copy of the page from their current insurance policy that
      identifies the amounts of coverage and expiration date.

3. Each driver agrees that when driving their personal automobile on District business, if they are
   involved in an accident, by law the owner’s liability insurance is used first. The District liability policy
   would only be used after the owner’s policy limits have been exceeded. The District does not cover,
   nor is it responsible for, comprehensive and collision coverage to the personal automobile.

4. Vehicles may not be overloaded. There must be a seat belt for the driver and each passenger. All
   occupants in the vehicle must wear properly functioning seat belts. No person under 5 feet in height,
   or 100 pounds in weight, may ride in the front passenger seat of a vehicle equipped with a passenger
   side airbag.

5. Vehicles must be registered in the state of California and be in proper mechanical condition.

6. All passengers must have on file with the school prior to the trip a completed and signed Field Trip
   Permission Slip.

Please sign below indicating that you are aware of this notification. ALSO attach a copy of the page from
your current insurance policy that identifies the amount of coverage and expiration date.

DRIVERS NAME (please print) ___________________________________________

DRIVERS SIGNATURE _________________________________________________

CALIFORNIA DRIVERS LICENSE NUMBER______________________________

NUMBER OF SEAT BELTS IN CAR FOR STUDENTS_______________________

INSURANCE COMPANY ________________________________________________

POLICY NUMBER______________________ EXPIRATION DATE____________

LIABILITY AMOUNT ___________________________________________________