Student Name:

Home Address:

Training Program: Class 5 GDL - Insurance Premium Reduction ($550 +GST)Advance Training ($550 +GST)Hourly Lessons ($50 +GST)Car Rental for Road Tests ($50 +GST for standard test, $80 +GST for advance test)

Pick up at: HomeOther

Gender: MaleFemale

Phone Number:
Persons under 18 are required to provide parents phone number as well

Current Drivers License:

Issued: Expiry: Date of Birth:


Email:
A copy of this registration form will be emailed to you.

Terms of Conditions:

1. Minimum 24 hour notice required for cancellation. Late cancellation will cost $100. Cancellation notification to be sent via text to (780) 904-4648
2. Student is liable for any traffic violations during training.
3. Full payment is required prior to any training. Payment can be made via: cash, certified cheque, money order, bank draft or e-transfer.
4. Classroom training to be completed within 3 months of enrolment date.

Enter your name in full to confirm that you accept these terms. If you are under 18, than your parent or guardian must see these terms and put their name below

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