Advanced Juvenile Driver Improvement Program

50%

Student Name*
First Last
Date of Birth*
Address*
Street Address City State ZIP Code
Teen Phone*
Mother's Name*
First Last
Mother's Email*
Father's Name*
First Last
Father's Email*
Parent Phone*
Judge's Name*
First Last
Drivers License Number*
Issue Date*
Car to be used for Training?*
Insurance Carrier*
Upcoming Training Dates
- August 10, 2020
- October 12, 2020
- December 21, 2020
7:45 am - 3:00 pm

Online Payment
Please select the appropriate price category. Then submit registration to begin your online transaction with PayPal.
Name on Credit Card*
First Last
Buyer's Email*
Advanced Juvenile Driver Improvement Program*
Price: $195.00 Quantity:
Total
$0.00
In consideration of my attendance at or participation in a DriveTeam, Inc. program or clinic:

1. I hereby knowingly and voluntarily waive forever any and all liability on the part of, and covenant not to sue or institute any legal claim against DriveTeam, Inc., its instructors, insurers, property owners, successors or assigns, or any sponsor, resulting from or arising out of or in connection with my attendance at or participation in a DriveTeam, Inc. program or clinic.

2. I hereby knowingly and voluntarily assume full responsibility for the risk of bodily injury, death, or property damage incurred by me as a result of my actions, or of any accident, collision, act of God or act or failure to act of DriveTeam, Inc. or of any sponsor, in connection with my attendance at or participation in a DriveTeam program or clinic.

3. This Waiver of Liability and Release shall be binding upon me and my personal representatives, assigns, heirs and next of kin.
Agreement*
- I agree with DriveTeam's Waiver of Liability & Release form

Online Payment