Please Mail both Page To: Atlantic Driving School,2231 Kuntz Ct.Mohave Valley, AZ 86440
928-715-3553 or text 928-727-2377 or e-mail email@example.com
You can also call in this information to register only for Traffic Survival School.
I am not scheduling any behind the wheel training as of 8/1/22.
Certified Trainer: Glenda Webb
First & Last Name________________________________________________________________
City & State, zip________________________________________________________________________
Cell phone number:_____________________________________________________________________
Date of Birth_________________________________________________________________________
Credit Card #__________________________________________________________________________
Last 3 # on back of card_________________________________________________________________
How much do you want to charge?________________________________________________________
Payments include payment plans. Checks, Money Order, Master Card/Visa. You can make advance payments before the class, the class must be paid in full on the day of class. Gift Certificates are available.
PAYMENT POLICY/ Waiver
Traffic Survival School should be paid in advance. There is a completion Certificate given to the student at the completion of class. DMV is notified within 6 hours of completion.
In no event shall Atlantic Driving School be liable for any consequences or incident damages due to the classroom . The total liability of Atlantic Driving School shall not exceed the total paid to Atlantic Driving School for services rendered.
I agree that the actual fees paid on my signed invoice reflect this limited liability and allocation of risk.
Signature _____________________________________________________________ Date____________________________