Student Registration Form - Roundabout Driving School

Hello, Let’s get to know you better. Please fill out the form carefully for registration prior to your first lesson.

Name *

First

Last

Email *

Phone Number *

Emergency contact phone #

What kind of driver are you?

Brand New Driver
Out of Province / Country
Looking for class 4R / 4U training
Senior or Medical Assessment called in for a road test.

How much experience do you have?

I drive very little or not at all
I drive regularly, just looking to fine tune my skills
I am looking for road test preparation

Today's Date of Registration

Date

Time

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

LDL or DL#

Road test date if known or eligibility date

Any special needs / concerns / instructions or notes.

In consideration of Roundabout Driving School enrolling me in their driver training lessons or programs and providing me use of their training vehicles and equipment, I / We agree as follows:

I agree to only attend driver training when I and all the members of my household are feeling healthy, I or any members of my household are not required to self-isolate and to the best of my knowledge have not been exposed to anyone sick with COVID 19.
I agree to completely release Roundabout Driving School and any companies owned by or associated with Roundabout Driving School as well as all representatives of Roundabout Driving School from any claims of physical or emotional injuries, damages, or death as well as any loss or expense that I or my next of kin may incur, as a result of my participation in driver training offered by Roundabout Driving School. I understand that Driver Training has obvious risks and incidents and accidents are possible despite best efforts.
I indemnify and hold harmless Roundabout Driving School and any owners, family members or next of kin and /or representatives from any liability, property damage or injury to any third party that may incur, as a result of my training offered by Roundabout Driving School.
I waive any and all claims against Roundabout Driving School, any of their affiliated and or associated companies and any or all of their representatives.
I agree that this agreement shall be effective and binding upon myself, heirs, next of kin, executors, administrators or assigns.
Underage Consent of Parent or Guardian - I, as the (Parent/Guardian (if underage student registered) hereby consent to his/her enrollment in the training program with Roundabout Driving School and agree to be bound by the conditions and limitations as stated above.

I have read and understood this agreement.

I understand that I am waiving legal rights which I or my heirs, next of kin, executors, administrators and or assigns, may now or in the future have against Roundabout Driving School and its owners, family members or school representatives.

I hereby acknowledge and accept these risks and give my consent to participate in Roundabout Driving School's driving lessons and training program. I /we understand and agree that lessons are video recorded for safety and training purposes and that lesson clips may be used for online training programs.

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