1924 Arlington Blvd, Suite A, Charlottesville, VA 22903
434-979-5300 Michael R. Jones – Owner
Behind the Wheel Contract for Students 17 and Under
Student Name: ______Student Cell # (_____) ______
Address: ______DOB______
Permit # ______Date Issued ______Home Phone # (_____) ______
Parent/Guardian Name: ______Cell phone # (_____) ______
How many hours of driving does the student have ______School student attend ______
Parents: As your child begins Behind the Wheel, please make sure they are driving as much as possible. Instructors will teach them new skills that will need to be practiced with you. Together, your child will develop great driving habits to become a confident and safe driver for the rest of their lives.
Fee for Behind the Wheel: $350.00 or $325.00* If you took the classroom portion at Green Light
Please fill in agreed upon dates:
1. Date______Day______Time______
2. Date______Day______Time______
3. Date______Day______Time______
4. Date______Day______Time______
5. Date______Day______Time______
6. Date______Day______Time______
7. Date______Day______Time______
GREEN LIGHT POLICIES
· $25.00 cancellation fee unless 48 hours’ notice is given
· $50.00 for cancelling the same day. (Same day means after 5 pm the day before the lesson)
· Payment is due upon registration and there is a $25.00 fee for returned checks.
· If a student/parent wants or needs extra lessons, the fee will be $50.00 per fifty minutes.
DMV POLICIES
· Students under the age of 18 are required by the State of Virginia to complete a state approved driver’s education program. The requirements for Behind the Wheel are fourteen fifty-minute periods of which seven periods are spent driving and seven periods are spent observing.
· A full or partial refund, depending on the number of hours completed, will be made upon request only if this school is incapable of or unwilling to perform its part of this agreement within one hundred twenty days of registration.
· The instruction provided by this school does not guarantee that any student will pass the state license examination or that the student can secure a driver’s license or the student will be guaranteed employment upon completion of course.
· Student has permission from parents if under eighteen, to receive one on one training with an instructor. The student is required to meet the observation requirements with at least one other student in the vehicle during in-car vehicle training.
· DMV is committed to providing transportation safety through the certification of quality driver training programs. If you have comments or concerns about this course, call their toll-free number 1-877-885-5790.
I have read and understand the information provided in this contract.
Parent Signature______Date ______
Instructor Signature ______Date ______