QualityDriverEducation.pdfVIP

Quality Driver Education 202 Main Street Pendleton, Indiana 46064 765-425-2252 Contract Registration Month of class:_________________ Date of application:______________ Last Name:__________________________________________ ? Male ? Female First Name:__________________________________________ Middle Initial: ______ Address:_________________________ City:_______________ Zip:________________ Birth Date:_____/______/________ Phone#:____________________ Parent Guardian Name:_____________________ Phone#:____________________ Emergency Contact Person:_________________________ Phone#:_________________ Doctor’s Name:__________________________ Phone:__________________________ This is a contract (registration) between Quality Driver Education, Inc. and the above student and parent guardian. In this contract, the parent/guardian agrees to pay the entire course fee prior to the first day of class for the described instruction and to abide by the rules and policies of Quality Driver Education, Inc. (See accompanying documents) Neither Quality Driver Education, nor its owners, officers, instructors, employees, or agents has made or shall be deemed to have made any representation or warranty regarding the student’s ability to secure a driver’s license to operate a vehicle upon completion of the driving instruction provided by Quality Driver Education. After completion of the course, the student must still meet any and all requirements established by the Indiana BMV before a driver’s license shall be issued. The course fee entitles each student to 30 hours of classroom instruction and 6 hours of driving instruction. **Parents/students have the option to purchase additional driving sessions beyond the minimum 6 hours.