Field Trip Chaperone - River City Believers Academy

Thank you for your willingness to serve as a chaperone! Please complete the form below at least 14 days before the field trip to be considered. All chaperones must have a current background check on file and provide copies of their driver’s license and auto insurance.

Name (First, Middle, Last) *

Present Address *

Address 1
Address 2

City

State

Zip

Date of Birth *

Phone Number *

Gender * (1 required)

Male Female

Driver's License Number *

Driver's License Issued State *

Upload Driver's License *

(allowed file types: heic, jpeg, jpg, pdf, png)

Current Auto Insurance Upload *

(allowed file types: heic, jpeg, jpg, pdf, png)

By typing my name below, I authorize River City Believers Academy to conduct a background check for the purpose of volunteering as a field trip chaperone. I understand that this background check may include, but is not limited to, a review of criminal history and sex offender registry status.

Electronic Signature *

Enter Your Email Address: *