Today's date:

Organization/Name:

Name of person in charge: Phone(s):

Address: Email:

Number of passengers:

TERMS and CONDITIONS for van use:

• All drivers must be 25 years of age and registered with Bethany Presbyterian Church insurance company.
• A seat belt must be worn by all passengers and drivers at all times.
• The van(s) must be fueled (full tank) before returning from a trip.
• The van(s) must be cleaned upon returning from a trip.
• The van(s) log sheet must be completely filled out upon return from a trip.
• Park the van(s) legally and respectfully upon their return.
• Report any problems encountered or which you became aware of concerning the van(s).
• Report any accidents or mishaps of any kind to the interior or exterior of the van(s).

I have read, understand and agree to these Terms and Conditions.

Signed: Date:

If your signature is not on file, please come to the Bethany church office to sign your form.