Next Level Driver Training Registration

Student's Name*
First Last
Address*
Street Address City State ZIP Code
Phone*
Please Select Registration Option*
Section - Over 18
Date of Birth*
MM slash DD slash YYYY

mm/dd/yyyy
Is he/she a DriveTeam Current Student/Graduate*
- Yes
- No
If no, he/she must be a licensed driver.
Section - Under 18
Child*
- Son
- Daughter
Date of Birth*
MM slash DD slash YYYY

mm/dd/yyyy
Mother's Name*
First Last
Mother's Phone Number*
Mother's Cell Phone Number*
Mother's Email*
Father's Name
First Last
Father's Phone Number
Father's Cell Phone Number
Father's Email

Online Payment
Please select the appropriate price category. Then submit registration to begin your online transaction with PayPal.
Name on Credit Card*
First Last
Customer Email*
Next Level Driver Training Student Quantity
Price: $295.00
Parent Name
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
Phone
This field is for validation purposes and should be left unchanged.

Section - Over 18