Capital City Vineyard Church Segment 1 Driver Education Training Registration

Student Name*
First Middle (No Initials, if no middle name, write None) Last
Address*
Street Address Address Line 2 City State ZIP Code
Parent Phone*
Parent Email*
Student Birthdate*
Month
Day
Year
Segment 1 Driver Education Classes at Capital City Vineyard Church*
Other Information
Note if the student has any medical, physical, learning, or disability condition here.
Total
$0.00
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 14 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 14 days or less of notice, Drive Right will refund 50% of the fee.
Payment*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Phone