Comprehensive Driving Program Driving School Location*Driver Training Inc. Bristol, VA/TNSelect a Driving School LocationClass Date*Please select the course date you would like to enroll in above.Class Type*$375 - Assessment, (split into two appointments)$500 - Classroom and Behind the Wheel, 36-60 minute sessionsPlease select the course you would like to enroll in above. Any behind the wheel classes will be scheduled separately taking into consideration the parent's/student's schedule. A non-refundable application fee of $40.00 is included in the amounts and there will be no refunds after 30 days. Special PricingPayment Method*Pay by CashPay by PayPal (You do not have to have a PayPal account), Visa, Master Card, AM EX, E-Check, etc...Unfortunately, we do not accept checks. THERE ARE NO REFUNDS AFTER 60 DAYS.Student InformationPlease enter "Full Legal Name"First Name*Middle NameLast Name*Date of Birth* MM DD YYYY AgeEmail* Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Phone Number*High School (if applicable)GradeDoes the student have a learner's permit or driver's license?*YesNoPermit/License Number*Date Issued* MM DD YYYY Expiration Date* MM DD YYYY Parent/Legal Guardian Name (under 18 years old) First Last Parent/Legal Guardian PhonePlease enter the Parent/Legal Guardian Phone: (###)###-####Parent/Legal Guardian Email TERMS OF AGREEMENT AND SCHOOL RULESTERMS OF AGREEMENTThere's a lot of important information here. Please scroll to the end to continue.TERMS OF AGREEMENT* I have read and agree to the Terms of Agreement (You must scroll through the TOA) DRIVING SCHOOL RULESThere's a lot of important information here. Please scroll to the end to continue.DRIVING SCHOOL RULES* I have read and agree to the Driving School Rules (You must scroll through the DSR) Keep up with the latest laws Yes, I would like to receive news and information via email Waiver of Liability*I have read and agree to the Waiver of Liability for DTII/We expressly agree to be responsible for my own welfare/my child’s welfare, and fully assume all the risks both known and unknown associated with Behind the Wheel/In-car driving lessons with Driver Training, Inc., voluntarily and knowingly, to the fullest extent permitted by law. If signed on behalf of the child, I have discussed the risks with the child and he or she wishes to participate in the driving course nevertheless. To the fullest extent permitted by law by the parent or legal guardian of the child, including my spouse, expressly release, waive, forever discharge, and covenant not to sue Driver Training, Inc., its owner, driving instructors, or employees from and against any and all liability, claims, causes of action, costs, damages, injury, losses or suits of any and every kind which the child now has or may later have against the released parties arising out of, or related to driving in connection with Driver Training, Inc. In addition, I agree to fully protect, defend and hold harmless Driver Training, Inc. with respect to losses as a consequence of my child’s own actions or inactions whether arising from Driver Training, Inc. instructor’s negligence or otherwise. I agree that the terms of this agreement shall serve as a complete release and express assumption of risk for my child on whose behalf I am signing this agreement, including the child. It is my intention to fully assume all risk associated with Behind the Wheel training and to release Driver Training, Inc. from any and all liability to the maximum extent permitted by law.