Driver Education Contract

(Owner: Dawn M. Spaid Phone:540-241-0901)
Office:1025B. W. Main Street Waynesboro, VA 22980
Mailing: P.O. Box 363 Stuarts Draft, VA 24477
Student’s Name: _______________________________ Date of Birth: _______/_______/_______
Address: ______________________________________ Permit Number: _______- ________-_________
City/State: ____________________________________ Telephone #: (H) __________________
Student’s Cell # ________________________ Can student receive text messages? Yes or No
I understand that in order to obtain a Virginia driver’s license, students under 19 years of age must complete thirty-six (36) classroom
hours and fourteen (14) fifty (50) minute behind the wheel periods of driver’s education along with forty-five (45) logged hours with a
mentor, fifteen (15) of which must be after sunset. A commercial driving school is not required for students over 19 years of age in
order to secure a driver’s license. If you are 19 years or older, you must hold a learner’s permit for at least 60 days or show proof of
completion of a state-approved driver education program. I grant permission to enroll my child in the behind the wheel section of
instruction which includes seven (7) driving and seven (7) observation periods. The following date is when BEHIND THE WHEEL
OR CLASSROOM instruction is scheduled to begin.
Start Date: ______________ Time: _____________
*Make checks payable to Augusta Driving School
I understand that the fee for BEHIND THE WHEEL is ____________ payable by cash-check-or MAJOR CREDIT CARD.
This amount is due in full prior to beginning of the first lesson, unless other arrangements have been made. I understand that the
balance must be paid in full, and any checks written MUST CLEAR before an Augusta Driving School Virginia Driver Training
Certificate (DTS-B) form will be issued. There are no refunds to be given after training has begun; however, should Augusta
Defensive Driving School be unwilling to begin instruction within 30days from the first scheduled date, a refund can be given if
requested. In the event the school cancels a scheduled day of behind the wheel, the instructor will notify the student to arrange an
alternate date. I understand that in order to pass behind the wheel instruction in the scheduled time, there must be no more thanten
(10) failure checks on the final road skills test score sheet checklist. There may also be NOchecks in the immediate failure portion of
final road skills test score sheet section. Additional skill assessments may be added at the teacher’s discretion. I realize that if my child
has an unexcused absence, or if any re-testing or additional training is needed due to student failing the road test or student isn’t
making sufficient progress by the last lesson, ex: driving instructor has to intervene in driving to prevent accident), there will be an
additional fee of $50.00 per training session.The driving instruction provided does not guarantee that a student will pass the state
license examination, that the student can secure a license, or that the student will be guaranteed employment upon completion of this
course. The Department of Motor Vehicles is committed to promoting transportation safety through the certification of quality driver
training programs. If you have comments or concerns about this course, call our toll free number:1-877-885-5790
The school also offers Classroom Driver’s Education Instruction. The fee for the CLASSROOM INSTRUCTION
alone is $200.00. However, should your student elect to take CLASSROOM INSTRUCTION AND BEHIND THE WHEEL,
the fee for BOTH PROGRAMS is $425.00.Augusta Defensive Driving School does not provide or offer the use of the school’s
vehicle in taking any driving tests to obtain a driver’s license from the Department of Motor Vehicles. I understand that it is unlawful
to make false statements on a licensing application and such violations are punishable by law as a Class 2 misdemeanor.
**NOTE: By signing this contract, I agree to all terms and conditions stated above.
Parent/Guardian’s Printed:
Signature: ____________________________
Student’s Printed:
Signature: ____________________________
Instructor’s Printed:
Signature: ___________________________
 Photo copy of learner’s permit
 Signed Certificate
of completion
from Driver’s
Ed Classroom