Passenger Registration Form

Please use the form below to register yourself as a passenger

Special Requirements : Tick if the following are to be carried in the vehicle:

Are you a Blue Badge Holder?

Can you get into and out of a car unaided?

Do you use a Wheelchair?

Do you use a Motorised Scooter?

Do you have a medical exemption from wearing a seat belt?

Are you partially sighted or registered blind?

Consent