Willow Glen Bible Church

VEHICLE LOAN FORM

THIS FORM IS INTENDED FOR OWNERS OF VEHICLES LOANED TO WILLOW GLEN BIBLE CHURCH FOR WGBC TRANSPORTATION.

If you would prefer to fill out a paper form and hand it in to the WGBC office staff, use the button below.

WGBC Vehicle Loan Form PDF

First Name

Last Name

Phone Number

Email

Address 1

Address 2

Country

City

State

Zip/Postal Code

Vehicle Make/Model

Vehicle License Plate #

Number of working seatbelts

Vehicle Registration Expiration Date

Insurance Company

Insurance Policy Number

Insurance Valid Until Date

The church recommends volunteer private vehicles to have a minimum amount of liability insurance. (1) $100,000 liability per person for bodily injury; (2) $300,000 liability per incident for bodily injury for all vehicle occupants; and (3) $50,000-$100,000 liability for property damage.

I understand that in case of any accident, injury, or vehicle damage, the church’s liability insurance policy does not provide primary or direct insurance on my vehicles. The church’s insurance is secondary only after my personal auto insurance limits are exhausted for liability, damage to other vehicle, and medical, and does not provide any property damage, uninsured motorist, comprehensive or collision coverage on my vehicles(s). Damage to any private vehicle is the responsibility of the vehicle owner. To my knowledge, my vehicle has a current, valid registration and operating license, is in safe operating condition (brakes, tires, etc.), and complies with all applicable state laws of California.

By signing below, I give permission to WGBC to use my vehicle for (name of event).

Typing my name is my signature

Date of signature

Submit

WILLOW GLEN BIBLE CHURCH

VEHICLE LOAN FORM

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