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Comments: *
* First Name:
* Middle Initial
* Last Name:
* Date Of Birth / / (MM/DD/YYYY)
* Address:
* City:
* State:
* Zip Code:
* Phone Number: () - Ext.
* E-Mail:

Create a login id and password to access the online behind the wheel schedule. Make this easy to remember, but hard for others to guess and write it down.

* Login Id:
* Password:
* Verify Password:
* Parent/Guardian Name
* Class
* Date and Time
* Payment Type

just drive will not refund any tuition or part of tuition if just drive is ready, willing, and able
to fulfill it's part of this agreement.

This written agreement constitutes the entire agreement between just drive and the
student/parent/guardian. No verbal statements or promises will be recognized.

I also agree to pay a fee of $35.00 for each behind the wheel lesson or observation session
not cancelled 24 hours in advance.

* I have read, understood, and accept this agreement.
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