Complete the form below to enroll for Additional Private Lessons

Bumper to Bumper School of Driving LLC
Manager: Bruce Larson

Bumper to Bumper School of Driving LLC

2132 54th St.

Somerset, WI 54025

Student Name*
First Middle Last
Email*
Date of Birth*
Date Format: MM slash DD slash YYYY
Name of School Attending
Parent Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Cell Phone*
Additional Private Lessons
Price: $50.00 Quantity:
$50/hour
I/We, hereby agree to the terms and conditions listed below.
1. LESSON CANCELLATIONS – If a student cannot make a scheduled behind - the – wheel (BTW) lesson they may cancel at least 24 hours in advance without a fee. For all lessons cancelled within the 24 hour window, a fee of $35.00 will be charged. The instructor may cancel a BTW lesson due to weather or other extenuating circumstances. Students will be notified in a timely manner. BTW lessons will be rescheduled.
2. COLLECTION OF FEES AND REFUNDS – Students and parents agree to pay all reasonable cost and fees incurred by the school for collection of any amounts owed by the student to Bumper to Bumper School of Driving LLC. Returned checks will be charged the original amount plus a fee of $35.00. Bumper to Bumper School of Driving LLC. will not refund any tuition or part of tuition if the school is ready, willing and able to fulfill its part of the agreement.
3. POLICIES FOR DISMISSAL – A student may be dis missed from the course at any time for the following reasons: A) If a student does not meet the Wisconsin State requirements for the course. B) Sleeping or cell phone use during the BTW lessons. C) Any activity that may interfere with another students learning.
4. AGREEMENT TERMS - This constitutes the entire agreement between Bumper to Bumper School of Driving LLC. the student/parents or adults. The agreement expires 1 year from the date of origination. No verbal statement or promises will be recognized.
Parent Signature*
Student Signature*
Date*
Date Format: MM slash DD slash YYYY

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