Cupertino High School Cross Country 2016
Home of the Pioneers
  Coach Paul Armstrong
Driving (students)
Note:
By state law students must have their license for 1 year before they may drive others who are not family.
Name____________________________________  Birthdate: ____________Date____________

_________Practices away from campus       ___________Meets 

Vehicle Make:________________________________________________

Year and Model:______________________________________________

Vehicle License Number(s):______________________________________


Driver's License Number:_______________________________________

     Issue Date:_______________________________________________

    Expiration Date:____________________________________________

 
Insurance Carrier:_____________________________________________

      Policy Number:___________________________________________

      Expiration Date:___________________________________________
 

Signature:___________________________________________________
Driver of vehicle

I am the registered owner of the vehicle described above on this form
and I authorize the driver, whose name appears above to use this vehicle
to transport him/herself and other students.  I certify that the information
provided above is correct.

Signature:___________________________________________________
Owner of vehicle
 
Parent Signature (if different from owner):_____________________________

This page last updated:  8/5/16
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