This form is required of anyone driving for club sports, this includes drivers of personal, rental and zip cars. This form requires an electronic signature. Name of your club sport: * - Select -ArcheryBadmintonBallroom DanceBaseballBasketball (M)Basketball (W)CricketCyclingEquestrianField HockeyFigure SkatingFishingGolfGymnasticsIce HockeyIndoor ClimbingJiu Jitsu, BrazilianJudoJump RopeKarate, ShotokanKendoKickboxing, Muay-ThaiKung Fu, Wing ChungLacrosse (M)Lacrosse (W)Pistol & RiflePlatform TennisPoloPowerliftingRoad RunningRoundnetRugby (M)Rugby (W)Skeet & TrapSki, AlpineSki, NordicSnowboardingSoccer C1 (M)Soccer C2 (M)Soccer C1 (W)Soccer C2 (W)SquashSwimmingSynchronized SwimmingTable TennisTae Kwon DoTennis (M)Tennis (W)TriathlonUltimate (M)Ultimate (W)Volleyball (M)Volleyball (W)Water Polo (M)Water Polo (W)WrestlingWushu Driver info Driver's name: * Driver's license number: * Driver's license state of issue: * Only US or Canadian licenses are allowed. Driver's license expiration date: * Driver's Safety Awareness class: * Yes No If you select NO you are not eligible to drive for club sports. You must have taken the Yale Driver's Awareness Class to drive for club sport purposes. Net ID: * Your driving record You must attest to a good driving record defined as (1) nothing more serious than a speeding or failure to obey traffic control infraction, (2) no more than 1 infraction in the past two years, (3) no at-fault accidents in the past two years. Do you attest that you have a good driving record as defined above? * Yes No Do you agree to obey all traffic laws? * Yes Will you be driving a personal car? * Yes No If you answer Yes you must fill out the next section regarding your personal car. Personal car info You must attest to the following: Your personal vehicle is up to date on all maintenance: Yes N/A (I am not driving a personal car) You have insurance with at least $300,000 combined single limit: Yes N/A (I am not driving a personal car) (If Vehicle is registered in parent's name) Your parent has given permission for use: Yes No, the vehicle is registered in my name N/A (I am not driving a personal car) Insurance company name: Insurance policy number: Expiration date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year1900190119021903190419051906190719081909191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 Snow Sports onlyAlpine Ski, Nordi Ski, Snowboarding clubs--You are required to take four wheel drive vehicles. Electronic signature stating all information above is correct: * CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.