Registration Full Form

Full Name:

Name Requested On Name Tag:

Phone Number:

Email:

Address:

City:

State:

Zip:

Date of Birth:

MonthDayYear

Are you proficient with manual transission?:

Request an automatic? (Corvette Only):

Date and Program of First Choice School (Please specify level):

NOTICE: All deposits are 50% down and NON-REFUNDABLE!

If a date change is necessary, a minimum of 30 day advanced notice must be given in order for the deposit to apply to the new date. If due notice is not given, the deposit shall be forfeited!

C6 Z06 Exclusive LV1-$995.00 / LV2-$1195.00 for the full duration of your school (Corvette Only):

Would you like more information on insurance options:

I hereby authorize Spring Mountain to run CC 2 weeks prior.

Have you attended a driving school before?:

If so, where and when?:

Will you have any food allergies, or health needs while attending our school?:

How did you hear about us?

What Vehicle(s) do you currently own?:

Please include specifics regarding above method if applicable:

Refer a Friend (they receive a $100 discount in the future):

Emergency Contact Information:

Name:

Phone:

Relationship:

Check here if this is a surprise gift for someone else:

If this is a surprise, who shall we contact for questions?

Name:

Phone:

Email:

Mail Gift Certificate to:

Street:

City:

State:

Zip:

Would you like to pay the full tuition or the deposit?:

(See above for deposit/full tuition amounts).

Should confirmation be sent in a plain envelope ((No return address or logo on correspondence)?:

Sentiment request on Gift Certificate? i.e., “Happy Birthday”, “I Love You”, etc.:

Which one of our representatives assisted you with questions, information, and booking?: