(910) 814-7383 [email protected] Monday - Saturday: 7:00AM - 6:00PM REVIEW OUR CLASS SCHEDULE Driver Education Contract/ Agreement "*" indicates required fields LEGAL NAME AS IT APPEARS ON YOUR BIRTH CERTIFICATE:First* Middle* Last* Date of Birth* Age*School* Home Address* City* Phone Number*Emergency Contact* Note, by selecting this checkbox you agree to the following:* 1. All fees for instruction are payable in advance. 2. Cancellations must be made at least 3 business days prior to the start of classroom instruction. You must call the office to request a cancellation. 3. Students may request additional time as an observer in the car with a behind the wheel student however, riding/ passenger time does not count toward actual behind the wheel time. Behind the wheel instruction is given on a one-on-one basis. If the student receiving the instruction agrees to have another student as an observer, both must be current Success Driving School LLC students, and a waiver must be signed by the pupil stating that they are aware that another student will be riding with them. Under this agreement, an instructor may not provide behind the wheel training to more than three individual students. 4. Behind the wheel instruction is conducted by appointment only. It is your responsibility to set up and adhere to the schedule with the driving instructor. Once the schedule is set, it is your responsibility to contact the instructor if you need to cancel or change the appointment. Success Driving School will charge a fifty ($50.00) dollar cancellation/ no-show fee if a student fails to cancel the appointment at least 24 hours in advance. This fee must be paid before the student can continue the instruction. 5. All books and educational materials are the property of the school and must be returned, in good condition, upon completion of the course ($35.00 fee) 6. No Certificate of Completion will be issued until all fees have been paid in full and educational materials have been returned. 7. Success Driving School LLC will complete the course in a reasonable length of time however, it cannot be held responsible for delays caused by mechanical failure, unsafe driving conditions due to bad weather, or any other reason over which it has no control. The school will give students as much advance notice as possible if a delay becomes necessary (or foreseen). 8. Parents and students understand that certain hazards and risks are inherent in the operation of motor vehicles. The student does hereby specifically assume all risks as may be incurred in the normal operation of a motor vehicle during the course instruction. All vehicles are fully covered with liability insurance. The student hereby FULLY and COMPLETELY releases Success Driving School LLC, its agents and employees, from any liability whatsoever, and from ANY and ALL claims or causes of action resulting or arising from any damage or injury suffered by the student during this course or any extension thereof, to the extent that such claims shall not be covered by the school’s insurance coverage. The student hereby further agrees to indemnify and hold the school harmless from any and all claims made against it for any damage or injury suffered by any person, company, corporation or other entity, growing out of the student’s operation of a school vehicle, or as a result of the student’s course of instruction, to the extent that such a claim is not covered by the school’s insurance coverage. 9. Success Driving School LLC cannot and does not guarantee that the student will pass the examination given by the Division of Motor Vehicles upon completion of the course. The school does agree to exert its best efforts in teaching the student to meet the requirements of the examinations. 10. This agreement constitutes the entire contract between the school and the student and any verbal assurances or promises not contained herein shall bind neither the school nor the student. 11. Success Driving School LLC will not refund any tuition monies or any part thereof when actual services have been rendered. 12. Success Driving School LLC is licensed by the State of North Carolina Division of Motor Vehicles. Student Signature*Date* Parent/ Guardian*Date* By Date EmailThis field is for validation purposes and should be left unchanged. Δ