Road Trip Review Form Please fill all required fields. If ineligible, please mark N/A. Camp Name * Required Co-Chair/Liaison Name(s) * Required You only need to put Liaison names if the co-chairs are unable to attend the road trip!Co-Chair Cell Number * RequiredCo-Chair/Liaison Cell Number: * RequiredNumber of Cars Traveling * Required- Select -1234567moreDriver 1 Name * Required Driver 1 Cell Number * RequiredDriver 2 Name Driver 2 Cell NumberDriver 3 Name Driver 3 Cell NumberDriver 4 Name Driver 4 Cell NumberDriver 5 Name Driver 5 Cell NumberDriver 6 Name Driver 6 Cell NumberDriver 7 Name Driver 7 Cell NumberHow Does this Road Trip Promote the Mission and Values of ATC? * RequiredDestination City * Required Destination- Homeowner Information * Required Please list the name(s) of the actual owners of the house you will be staying in.Homeowner Affiliation with ATC * Required How are these people related to the organization? Ex) Parent of co-chair Jane Doe, etcDate and Time Departing for Destination * Required Date and Time Arriving at Destination * Required Date and Time Departing for College Station * Required Date and Time Arriving in College Station * Required Specific Description of Travel Route, Including Scheduled Stops * RequiredBe specific, i.e. use names of roads and cities you plan to stop at along the way.Contact Information at Destination * Required Number of ATC Staff Members Travelling * Required This includes directors and chairs.Car 1 Information * RequiredYou must include the following: 1) Driver's Name, 2) Driver's Cell Phone Number, 3) Vehicle Make & Model, 4) License Plate Number, 5) Driver's License Number, 6) State of Driver's License Issue, 7) Auto Insurance Company, and 8) Auto Insurance Policy Number. Please start a new line for each item required, and number each item according to the above list.Car 2 InformationYou must include the following: 1) Driver's Name, 2) Driver's Cell Phone Number, 3) Vehicle Make & Model, 4) License Plate Number, 5) Driver's License Number, 6) State of Driver's License Issue, 7) Auto Insurance Company, and 8) Auto Insurance Policy Number. Please start a new line for each item required, and number each item according to the above list.Car 3 InformationYou must include the following: 1) Driver's Name, 2) Driver's Cell Phone Number, 3) Vehicle Make & Model, 4) License Plate Number, 5) Driver's License Number, 6) State of Driver's License Issue, 7) Auto Insurance Company, and 8) Auto Insurance Policy Number. Please start a new line for each item required, and number each item according to the above list.Car 4 InformationYou must include the following: 1) Driver's Name, 2) Driver's Cell Phone Number, 3) Vehicle Make & Model, 4) License Plate Number, 5) Driver's License Number, 6) State of Driver's License Issue, 7) Auto Insurance Company, and 8) Auto Insurance Policy Number. Please start a new line for each item required, and number each item according to the above list.Car 5 InformationYou must include the following: 1) Driver's Name, 2) Driver's Cell Phone Number, 3) Vehicle Make & Model, 4) License Plate Number, 5) Driver's License Number, 6) State of Driver's License Issue, 7) Auto Insurance Company, and 8) Auto Insurance Policy Number. Please start a new line for each item required, and number each item according to the above list.Car 6 InformationYou must include the following: 1) Driver's Name, 2) Driver's Cell Phone Number, 3) Vehicle Make & Model, 4) License Plate Number, 5) Driver's License Number, 6) State of Driver's License Issue, 7) Auto Insurance Company, and 8) Auto Insurance Policy Number. Please start a new line for each item required, and number each item according to the above list.Car 7 InformationYou must include the following: 1) Driver's Name, 2) Driver's Cell Phone Number, 3) Vehicle Make & Model, 4) License Plate Number, 5) Driver's License Number, 6) State of Driver's License Issue, 7) Auto Insurance Company, and 8) Auto Insurance Policy Number. Please start a new line for each item required, and number each item according to the above list.Agenda/Itinerary of Trip With Approximate Date and Time * RequiredPlease provide a description of the activities you have planned with an estimation of what day/time you will do them.Activities * RequiredPlease list, and number, all the activities you have planned out in the itinerary. For example, 1. Travel to destination. 2. Team Building Activity outsidePhysical Risks * RequiredUse this field to list any associated risks there may be with the Activities you listed above, your numbers should correspond to the number of the activity above. For Example, 1. Drowsy Driving (corresponds to Travel to destination activity above). 2. Bad weather, physical injury (corresponds with Team Building activity outside from above field).Plans to Mitigate Physical Risks * RequiredPlace your plans to mitigate the risks you listed above. Again your numbering should correspond with the Activity and the Associated risks listed above. For Example, 1. Leave at a reasonable time with well- rested drivers ( corresponds to Travel to Destination Activity and the risk of Drowsy Driving). 2. Backup activity in case of rain, do the activity in an area with enough room that is clear of obstructions ( corresponds to Team Building Activity Outside and the risks of bad weather and physical injury)Directions to Hospital from Your Destination * RequiredBe specific, i.e. use names of roadsEmotional Risks * RequiredUse this field to list any associated risks there may be with the Activities you listed above, your numbers should correspond to the number of the activity above. For Example, 1. Drowsy Driving (corresponds to Travel to destination activity above). 2. Bad weather, physical injury (corresponds with Team Building activity outside from above field).Plans to Mitigate Emotional Risks * RequiredPlace your plans to mitigate the risks you listed above. Again your numbering should correspond with the Activity and the Associated risks listed above. For Example, 1. Leave at a reasonable time with well- rested drivers ( corresponds to Travel to Destination Activity and the risk of Drowsy Driving). 2. Backup activity in case of rain, do the activity in an area with enough room that is clear of obstructions ( corresponds to Team Building Activity Outside and the risks of bad weather and physical injury).Reputation Risks * RequiredUse this field to list any associated risks there may be with the Activities you listed above, your numbers should correspond to the number of the activity above. For Example, 1. Drowsy Driving (corresponds to Travel to destination activity above). 2. Bad weather, physical injury (corresponds with Team Building activity outside from above field).Plans to Mitigate Reputation Risks * RequiredPlace your plans to mitigate the risks you listed above. Again your numbering should correspond with the Activity and the Associated risks listed above. For Example, 1. Leave at a reasonable time with well- rested drivers ( corresponds to Travel to Destination Activity and the risk of Drowsy Driving). 2. Backup activity in case of rain, do the activity in an area with enough room that is clear of obstructions ( corresponds to Team Building Activity Outside and the risks of bad weather and physical injury).Financial Risks: * RequiredUse this field to list any associated risks there may be with the Activities you listed above, your numbers should correspond to the number of the activity above. For Example, 1. Drowsy Driving (corresponds to Travel to destination activity above). 2. Bad weather, physical injury (corresponds with Team Building activity outside from above field).Plans to Mitigate Financial Risks * RequiredPlace your plans to mitigate the risks you listed above. Again your numbering should correspond with the Activity and the Associated risks listed above. For Example, 1. Leave at a reasonable time with well- rested drivers ( corresponds to Travel to Destination Activity and the risk of Drowsy Driving). 2. Backup activity in case of rain, do the activity in an area with enough room that is clear of obstructions ( corresponds to Team Building Activity Outside and the risks of bad weather and physical injury).Facility Risks * RequiredUse this field to list any associated risks there may be with the Activities you listed above, your numbers should correspond to the number of the activity above. For Example, 1. Drowsy Driving (corresponds to Travel to destination activity above). 2. Bad weather, physical injury (corresponds with Team Building activity outside from above field)Plans to Mitigate Facility Risks * RequiredPlace your plans to mitigate the risks you listed above. Again your numbering should correspond with the Activity and the Associated risks listed above. For Example, 1. Leave at a reasonable time with well- rested drivers ( corresponds to Travel to Destination Activity and the risk of Drowsy Driving). 2. Backup activity in case of rain, do the activity in an area with enough room that is clear of obstructions ( corresponds to Team Building Activity Outside and the risks of bad weather and physical injury).Names of All Students and Staff Attending the Road Trip * RequiredInformation to Be Discussed with Adviser Have you had each member complete and return a release form for the current year? Have you filled out and submitted the Road Trip Review form to the Director of Administration? Have you filled out a Driver Agreement Form for each person driving a personal, rental or university vehicle? Have you assigned passengers to each vehicle? Do you have at least one first aid kit in all vehicles traveling? Have you established rules and communicated these for the trip? Have you clearly communicated an official start and end time for the trip? Do you know where the closest hospital is in the event of an emergency? Do you have directions to your destination in each vehicle? Do you have contact information for each vehicle? Do you have emergency contact information? Do you have copies of release forms for each person on trip? Do you have copies of driver agreement forms for each driver?