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Location*

Class Dates and Times*

Student's Full Legal Name*

First Middle Last

Date of Birth*

Student Cell Phone*

Parent Cell*

Email*

Enter Email Confirm Email

Address*

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

High School Student Attends*

How did you hear about Teens Inc?*

Additional Comments

Free Parent Class*

Parent Class - Yes, I am interested and will register on the website.
Parent Class - No, I am not interested.

Our Parent Meetings are free to EVERYONE. They are interesting and enjoyable. You owe it to your financial future to come and see why you and your teenager are at risk. We will hold a Parent Meeting to answer any questions you may have concerning our teaching style, credentials, and experiences. We will cover the Graduated Licensing process, accident avoidance, and how new laws will apply to your new driver. We will also go over how you as parents can help your son or daughter become a better driver. This meeting is HIGHLY RECOMMENDED for ALL PARENTS!

Parent Signature - I agree to requirements listed below:*

First Last

1. This contract expires 2 years from the first day of classroom training or when the student turns 18, whichever occurs first. All classes and BTW lessons must be completed before the expiration date. Any refund must be requested in writing before the expiration date.

2. If you choose to break up the classroom and BTW payment, the BTW portion will be billed at the rate current for that time.

3. If you choose to delay the Gas Surcharge Fee, you agree to pay the current rate at time of billing.

4. The first BTW lesson must be completed within the first four months from the date the student received their permit (fee may apply).

5. You can only schedule 1 BTW lesson at a time and the student should practice for at least 1 month between lessons.

6. This agreement constitutes the entire contract between the school and the student/parent. No verbal statements or promises will be recognized.

REFUND POLICY: Registrations that are cancelled less than 7 days prior to the class start date are subject to a cancellation fee of $25. Any refunds after class has started are subject to a $25 fee. Cancellations more than 7 days from the class start date, will be refunded in full less a $10 fee for credit card refund processing fee. There is no refund once class has started.