Driver Declaration Form - Policy

As part of the Transport Safety Policy, all Drivers with responsibility for providing transport during a program are required to complete this Form.

The Driver's Declaration Form is to be signed every three (3) years or when any details on this Form change, or if your licence is suspended or cancelled.  All personal information recorded on this Form will be kept confidential and recorded in our Church Management System which is maintained by the Safety Contact Person.

Driver's Information

Vehicle Information

If providing a vehicle (car or boat), please provide the following details:

Driver's Declaration

As the named driver on this form, I declare that:

  • I have read and understood the Transport Safety Policy.
  • I will drive carefully and follow all Victorian Road Laws and/or Victorian Marine Safety Regulations.
  • I will ensure that all passengers wear a seat belt when in a motor vehicle
  • I will ensure that all passengers wear a life jacket as required by the Victorian Marine Safety Regulations when in a boat/PWC.
  • I will provide a registered, roadworthy and insured vehicle.
  • I will only use a mobile phone or inbuilt device whilst driving in accordance with the road rules.
  • The information provided in this form is correct and indicates my commitment to the safety and welfare of all those for whom I am responsible.

Alcohol & Drug Policy - Driver's Commitment

As the named driver on this form, I declare that I have read and understand the Alcohol & Drug Policy.

As a driver, for and on behalf of Berwick Church of Christ, I recognise the detrimental effects that drugs and alcohol may have on the safety of driving a vehicle or vessel and the general health and wellbeing of individuals.

I will ensure that every time I undertake driving any vehicle or vessel and in particular bus safety work, as defined under section 3 of the Bus Safety Act 2009 (Vic):

  • I will have no drugs or alcohol present in my blood or breath immediately before, or while undertaking driving
  • I will inform my treating health practitioner or pharmacist of my policy obligations when being prescribed medications.
  • I am not impaired by drugs or medications.