Personal Vehicle Liability Form (Electronic)

Coastal Carolina University Personal Vehicle Travel Liability and Insurance Form

Coastal Carolina University Personal Vehicle Travel Liability and Insurance Form

All students requesting to drive their personal vehicle to a university sponsored off
campus class or activity must sign a Personal Vehicle Travel Liability and Insurance
Form before driving to the class or activity.

All students requesting to ride with a peer in their personal vehicle to a university sponsored off
campus class or activity must sign.

First & Last Name:

CCU Email:

Dates of Travel:

Organization you are traveling with:

Are you the driver or passenger for the trip?

Driver

Passenger