Serving southern Vermont since 2005

Teen Registration Form

Please compete the following form and click the submit button at the bottom.

Student name

Name parent/guardian

Title

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Work Phone

Home Phone

Parent email

Student email

You are registering for the following driving course session:

I am registering for the

Student's birth date:

Learner's Permit number:

Gender:

Choose one of the following payment options:

Credit card
Check

Agreement:

· I wish to make application to participate in the Westminster Driving School Driver
   Education Program. I am willing to give the necessary time and effort in order to
   fulfill the requirements of this accredited course, as prescribed by the Vermont
   Department of Motor Vehicles.

· I understand that the classes fill up on a first-come-first-served basis.

· I understand that if I am accepted into a session, the registration fee is
nonrefundable.

· I understand that I am covered by school insurance while driving in the Westminster
   Driving School driver education vehicle only and that I am required to drive additional
   hours outside of class with a parent/guardian who has insurance coverage on their
   personal vehicle.

· I understand that I must have and bring my Vermont Learner’s Permit to
   every behind-the-wheel lesson. To cancel a pre-arranged lesson, I must notify the
   instructor at least one day in advance. If I do not bring a driving permit,
   do not bring required glasses/contacts, do not appear for a drive, or do not
   notify the instructor in a timely fashion, I will pay a $50.00 (one hour session)
   cancellation fee before the next drive.

· I understand that I must have my Vermont Learner’s Permit BEFORE the Driver Education
class begins unless I’ve made other arrangements with the school.

Teen Registration Form

Westminster Driving School LLC Revised: January 11, 2010

Westminster Driving School LLC
Revised: January 11, 2010