Complete this form to pay for Behind the Wheel lessons. Student's Full Legal Name* First Middle Last Email* Enter Email Confirm Email Behind the Wheel Lessons* 1 - 2hour lesson $70 + $5 gas fee 3 - 2hour lessons $210 + $15 gas fee Total $0.00 Credit Card* DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Expiration Date Security Code Cardholder Name Parent Signature - I agree to requirements listed below:* First Last REFUND POLICY: All sales are final. There are no refunds. Δ