LEARNER DRIVER APPLICATION FORM
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  • EMERGENCY CONTACT DETAILS

    Please supply details for 2 emergency contacts. These should be responsible adults who, for example, can assist you to travel if necessary
  • MANAGEMENT PLAN FOR PRE-EXISTING INJURY/CONDITION

  • INFORMATION ABOUT THE CONDITION/INJURY

  • E.g. Self medication, avoidance of allergy triggers (specify) etc
  • CONDITIONS OF PARTICIPATION


    I have notified the Project Manager of any relevant medical conditions and pre-existing injuries, and I consent to the Project Manager rendering or authorising such medical treatment as necessary and accept responsibility for all associated expenses.

    I am a participant of the Learner Driver Program.

    I will not smoke, consume or store alcohol or illicit drugs while participating in the program.

    I shall respect the rights, feelings and property of all others associated with the Learner Driver Program.

    I shall co-operate with the program manager and volunteers to ensure a safe, happy & hygienic team environment.
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