4 Hour Winter Skills Clinic Registration
Student's Name: DOB:
Address: City: Zip: Son: Daughter: Is he/she a DriveTeam Graduate: Yes No Mother's First Name: Mother's Last Name:
Mother's Phone Number: Mother's Work/Cell Number: Mother's Email:
Father's First Name: Father's Last Name:
Father's Phone Number: Father's Work/Cell Number: Father's Email:
Drivers License #: Issue Date :
Car to be used for Winter Skills training*:
Make: Model: Year:
Auto insurance carrier for student and car to be used:
Available Dates: Please check the date you will be attending this 4 hour clinic. DTI Location: 4445 State Road Performance Driving Range
Waiver of Liability & Release Form
In consideration of my attendance at or participation in a DriveTeam, Inc. program or clinic: 1. I hereby knowingly and voluntarily waive forever any and all liability on the part of, and covenant not to sue or institute any legal claim against DriveTeam, Inc., its instructors, insurers, property owners, successors or assigns, or any sponsor, resulting from or arising out of or in connection with my attendance at or participation in a DriveTeam, Inc. program or clinic. 2. I hereby knowingly and voluntarily assume full responsibility for the risk of bodily injury, death, or property damage incurred by me as a result of my actions, or of any accident, collision, act of God or act or failure to act of DriveTeam, Inc. or of any sponsor, in connection with my attendance at or participation in a DriveTeam program or clinic. 3. This Waiver of Liability and Release shall be binding upon me and my personal representatives, assigns, heirs and next of kin. I agree with DriveTeam's Waiver of Liability & Release form
*We have found that certain light trucks and sport-utility vehicles are not stable enough for driver training. Accordingly, we cannot allow the following vehicles to be used for the Winter Skills course: Chevy/Geo Tracker; Conversion vans with raised roofs; Dodge Raider; Suzuki Samurai and Sidekick; 1995 and earlier Jeep CJ/Wrangler
