Paulding DETOUR Class Registration

Student Contract Number

Student Information

Student Name(Required)

First Last

Student Phone(Required)

Student Email(Required)

Student Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Student Date of Birth(Required)

Student License/Permit Number (if available)

Enter your permit or Driver’s License or Permit Number. If you currently have a State issued ID, use that number.

Is the Student Under 18?(Required)

Yes, I am Under 18

No, I am Older than 18

Parent/Guardian Name(Required)

First Last

Parent/Guardian Email(Required)

Parent/Guardian Phone(Required)

Will a parent/guardian attend with you?(Required)

Yes.

No.

Important: Which court referred you to this course?(Required)

Other Court / Other Referral(Required)

If your court wasn’t listed above, or if you were referred by somewhere else, please specify.

Choose Your Class Date

In the drop-down below, select your class date.

Select Your Class Date(Required)

Terms of Agreement

Paulding DETOUR Terms of Agreement

The student’s successful completion of the above-named course requires each of the following:

1. Attendance at all classes sober and free from illicit drugs.
2. Attendance on time for all sessions.
3. Reasonable attentiveness and participation in all classes.
4. Attendance at all sessions unless medically excused.
5. Completion of any court mandated or requested tasks in relation to this program.

West Metro Driving School will not refund any tuition or part of tuition if the School is ready, willing, and able to fulfill its part of this contract. I understand that if I fail to comply with the terms and conditions of this agreement, I am in breach of contract and the school will not be under any obligation to fulfill the terms of this contract, and may, at its option, terminate this agreement immediately.

It is agreed that an owner, instructor, or employee of this School shall not give the impression to a student that upon completion of their instruction this School will guarantee the securing of a driver’s license to operate a motor vehicle.

This agreement constitutes the contract between the above-named School and the above-named student or their Parent/Guardian and no verbal statements will be recognized.

Accept Terms(Required)

I agree to the Terms of Agreement.

Payment Information

Pay for class(Required)

Price:

Credit Card Information(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

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