Capital City Vineyard Church Segment 1 Driver Education Training Registration

Student Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Birthdate*
Date Format: MM slash DD slash YYYY
Segment 1 Driver Education Classes at Capital City Vineyard Church*
Total
$0.00
Other Information
Note if the student has any medical, physical, learning, or disability condition here.
Refund Policy
To facilitate social distancing, Michigan Department of State has instituted a strict policy limiting the number of students that may be registered to attend Segment 1 and Segment 2 driver education classes.

Consequently, if you must drop out of a Segment 1 or 2 class and provide Driving Right with greater than 7 days of notice, Drive Right will refund 100% of the fee.

If you must drop out of a Segment 1 or 2 class and provide Driving Right with 7 days or less of notice, Drive Right will refund 65% of the fee.
Payment*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name