DearLCSparents,

Inanefforttocomplywithourinsuranceregulations,youmusthavethefollowinginformationonfilewiththeschoolbeforeyouwillbeabletotransportLCSstudentsonanyfieldtrips.Pleasecompletethefollowingstepslistedbelow.

1. Completeall“LCSVolunteer”formsandattendaVolunteerTrainingsession.Theformsandtrainingsneedtoonlybecompletedonceduringyourstudent’senrollmentatLCS.

2. CompleteandreturntheattachedRequestforMotorVehicleRecordsCheckform.(Minimumrequirementsarenomorethanoneminormovingviolationinthepast3years,noDUIorDWI,andnospeedingticketswithspeedsof15milesoverthepostedspeedlimit.Minimumageis25andmaximumageis70).

3. Provideproofofcurrentinsurancewiththefollowingamountsofcoverage:$100,000bodilyinjuryperperson$300,000bodilyinjuryperaccident$100,000physicaldamage(driver’spolicyisprimarycoverageandschool’spolicyissecondarycoverage)Todothis,simplyphotocopyyourdriver’slicenseandinsurancecardononepieceofpaper.

4. Youwillalsoneedtohaveyourcarinspectedbyacertifiedmechanic.He/shewillneedtocompletetheattachedVehicleInspectionReport.AutomotiveSpecialistsat1377PleasantStreetwillperformcomplimentaryinspectionsforLCSfamilies.IfyouchoosetohaveyourvehicleinspectedbyAutomotiveSpecialists,pleasecontactthemtomakeanappointmentat773-0322.

Allreturnedformswillbereviewedbytheadministrationandkeptonrecordintheschooloffice.Formsneedtobecompletedeachschoolyearandarevalidforthatschoolyearonly.

Theprocesscanbedeclined,andinthatcase,youwouldnotbeabletotransportourstudentsonfieldtrips.Withstep#1completed,youwouldbeabletoattendfieldtrips,butcouldonlytransportyourownchildren.

Thankyousomuchforyourcooperation.Wearealwayswillingtoansweranyquestionsyoumayhaveandweappreciateyourunderstandingandsupporttoinsurethesafetyofourstudentsandstaff.

470 Lakeview Drive, Noblesville, IN 46060 • Phone 317.776.4186 Fax 317.776.4189 • www.LegacyChristianOnline.org

VEHICLE INSPECTION REPORT

(to drive on school-sponsored fieldtrips)

Vehicle Owner:

Inspection Completed By: Date:

Vehicle Make: Model: Year: Plate No.:

Beginning Mileage: Ending Mileage:

Not OK

OK

Before Starting Engine Not OK

OK

After Starting Engine

Body Brakes Brake / head / tail / clearance lights Parking brake Direction signals Drive train Emergency flashers (4-way) Gauges (oil / fuel / temp / air) Glass / mirrors (inside & outside) Heater / defroster / air conditioner Wheels and tires Speedometer - Air pressure to manufacturer’s recomm. Steering - Minimum of 1/8 inch tread depth Transmission - No visible sign of tire deterioration Checked for open safety recalls

(only for GM vehicles): Windshield wipers and washers Horn Seat belts all seating positions Remarks: Seats securely fastened to the floor Battery Belts Fluid levels / leaks Muffler & exhaust system Suspension system Other:

Condition of above vehicle is _Satisfactory Unsatisfactory

Driver’s Signature: Date

Inspector’s Signature Date

REQUEST FOR MOTOR VEHICLE RECORDS CHECK I hereby request the Bureau of Motor Vehicles to release information which pertains to any record of driving records contained in its files or in motor vehicle file maintained on me whether local, state, or national. I hereby release the said agency from any and all liability resulting from such disclosure. Name: Signature: _

Maiden Name (if applicable) _

Print any and all aliases: _

Date of birth: _

Place of birth: _

Social Security number: _ _

Driver’s license number: _ State issued: Today’s date:

Record sent to: Name: Legacy Christian School

Attn: Lynda Shade 470 Lakeview Drive Noblesville, IN 46060

470 Lakeview Drive, Noblesville, IN 46060 • Phone 317.776.4186 Fax 317.776.4189 • www.LegacyChristianOnline.org