Name (Required)

Email Address (Required)

Select the Sunday or Wednesday that you require a ride. (Required)

What is your full address? (Required)

I understand that submitting this form does not guarantee a ride, and that someone will contact me to confirm driver availability. (Required)

I understand that while Listowel Pentecostal Church does its best to ensure safe transportation, I accept the risks involved in traveling with a volunteer driver and will not hold the church or its volunteers liable in case of accident or injury. (Required)