Vehicle Hire Driver Registration Form Personal DetailsDetails are kept on file for a year unless requested otherwise.Name(Required) First Last Date of Birth(Required) DD slash MM slash YYYY Group/Organisation(Required)Email(Required) Driving Licence DetailsLast 8 Characters of Licence Number(Required)DVLA Check Code(Required)The DVLA check code allows us to check your driving record and is standard practice when hiring a vehicle. This can be accessed at www.gov.uk/view-driving-licenceDriver History DetailsHave you been convicted during the past 5 years of any offence in connection with a motor vehicle?(Required) Yes No At any point have you been disqualified from driving?(Required) Yes No Have you any prosecutions or police enquiries pending for motoring offences?(Required) Yes No Have you currently, or have any history of, any condition or disability which may affect your ability to drive safely now or in the future?(Required) Yes No Have you been involved in any accidents, losses or damages in respect of any vehicle within the last five years, whether or not a claim was made and regardless of blame.(Required) Yes No Are you currently taking any medication which may affect your driving ability?(Required) Yes No As you have answered yes to a question above, please provide more information.(Required)DeclarationI accept the declaration(Required) I declare that the details given are correct and that within my knowledge, there is no other material fact which should be disclosed. I have read and agree to the Vehicle Hire Terms and Conditions. I agree to exercise all due care for the safety of my passengers and the security of the vehicle whilst it is in my charge and I also undertake to inform of any accident that occurs whilst I am responsible for the vehicle. I understand that it is an offence under the Road Traffic Act to knowingly make a false statement to obtain insurance cover. I undertake to advise of any subsequent illness, condition or event which might affect my suitability as a minibus driver and including any subsequent refusal of motor insurance or any driving convictions. I understand that failure to do so and any false declaration made above may render the insurance cover for the vehicle invalid and that I may then be held personally liable to pay costs or damages. I understand that all information will be treated in the strictest confidence.
