Double Check Your Answers
If the answer to questions 5, 6 or 7 is yes, then the parent/guardian of a Segment 1 student must provide a letter signed by the student's physician indicating that the condition has been corrected and/or is under control, and the student meets the physical and mental requirements for a motor vehicle operator's license under Section 309 of the Michigan Vehicle Code, 1949 P A 300, MCL 257.309.
authorize MR.R’S A+ DRIVING SCHOOL, to allow a certified instructor employed by the provider, to Offer my child On-The-Road driving instruction without another passenger in the vehicle.
CERTIFICATION: I certify that the information on this form is true and accurate to the best of my knowledge.
FURTHER WE, THE UNDERSIGNED, UNDERSTAND THE ABOVE PROVISIONS & TERMS
IMPORTANT
We will need to schedule 6 drives for your student. These drives are normally scheduled in two hour blocks(1 period observation/1 period driving). We need to know when your students WILL NOT be available for drives for the 4 weeks begining on their first day of Drivers Ed. Try to be as generous as possible, we will be scheduling 20 or more students. 20 students means 20+ busy families. Please think in terms of their Transportation, School, Sports, Extracurricular and Family Activities. Select the time periods when your student WILL NOT be available to drive.
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