Student's Name *

First Name

Last Name

Student's Date Of Birth *

MM

DD

YYYY

Student's Phone Number *

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Guardian 1's Name *

First Name

Last Name

Guardian 1's Phone *

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Guardian 2's Name

First Name

Last Name

Guardian 2's Phone

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Terms Of Registration *

GRADING / PROGRESS ·The student has 90 days to complete the course. Course extensions can be purchased for a $40 fee after the course has expired by contacting the office via email or calling 1-208-461-4200. Course extension will extend the course for an additional 30 days. DRIVING LESSON CANCELLATIONS -If a student fails to keep a Behind The Wheel (BTW) lesson, they will be charged a $50 make-up fee that results in a driving schedule change. There is no charge for cancellations due to family emergencies providing the student contacts the instructor prior to the start time of the lesson. The Instructor may cancel a BTW lesson due to weather or other extenuating circumstances and students will be notified in a timely manner at no additional charge. BTW lessons will be rescheduled once fee is paid. AGREEMENT TERM and REFUND POLICY - This agreement expires one (1) year from the start date of the class. Nampa Driving Academy has a NO REFUND policy.

I agree to the preceding terms regarding the registration and subsequent completion of this course.