Troop 90 Transportation and Driver Information
Scout's Name: _________________
Date: ____________
	Vehicle # 1	Vehicle # 2	Vehicle # 3
Year
Make
Model
Number of passengers with seat belts, including driver
Owner's Name
License Plate Number
Insurance Carrier
Liability Insurance Coverage (must have minimum required by the state of PA: the recommended amount is 50,000/100,000/50,000
Each Person
Each Accident
Property Damage
Driver Information	Mother	Father	Other
Name
Driver's License Number
State isssued