FALL 2024 Driver Education

Driver Education Registration – 2024 – FALL

**Students MUST BE 14 by November 9, 2024**

INSTRUCTOR: Joe Lehman

LOCATION: Georgia Morse Middle School, Room 300
309 E Capitol Ave
Pierre, SD 57501

COST: $455 (This includes 30 hours of classroom instruction and 6 hours of behind-the-wheel instruction)

PARENT/GUARDIAN REQUIRED MEETING: Wednesday, October 8 at 7pm

CLASSROOM INSTRUCTION DATES: Tuesday, October 15 – Friday, November 8, 2024, excluding Wednesdays

CLASSROOM INSTRUCTION TIMES: 3:40 p.m. – 5:40 p.m.

BEHIND-THE-WHEEL INSTRUCTION: All 6 hours will be scheduled with the Instructor during class time

An email with class information/syllabus and a parent/guardian expectations meeting will occur prior to the class starting. It is Capital City Campus’ policy that the syllabus will be reviewed and signed by both the student and parent/guardian (if the student is under 18 years of age) and turned in prior to the student driving.

Thanks again for choosing Capital City Campus for your Driver Education needs!

"*" indicates required fields

Student Name*

First Last

Student Cell Phone Number*

Address*

Street Address City State ZIP

Date of Birth (must turn 14 on or by November 9, 2024)*

Grade for the 2024/2025 School Year

Is there anything you would like to share with the instructor about your child? (i.e. very shy, wears hearing aid, etc.)

Parent/Legal Guardian Name*

First Last

Parent Cell Phone*

Parent Email*

Parent 2/Legal Guardian Name

First Last

Parent 2/Guardian Email

Parent 2/Guardian Cell Phone

Parent/Legal Guardian Consent*

By submitting this form, I certify that I am the parent/legal guardian of the student and give permission for my student to participate in all portions of the program. The student is not currently using any medications that induce drowsiness or otherwise cause impairment. If the student has epilepsy, the student has been seizure-free for at least 6 months and documentation of such is readily available. If the student has a hearing or visual impairment, the student will wear (if needed) any eyewear or hearing apparatus required to operate a motor vehicle safely. The student will not have used alcohol or any drug in the 24 hours preceding participation in the program. I understand that although the program is intended to improve driver skills and that CCC will take reasonable safety precautions, there are both known and unanticipated risks which could result in severe personal injury, death, or property damage, as well as liability for myself and the student relating to the student’s operation of a vehicle. I release, waive, and indemnify CCC from and against any and all claims and liabilities. If a collision occurs for which the student is in any way responsible, I understand and agree that I will be responsible for all damages resulting therefrom.

Yes, I agree.

2024 Driver Education Course – FALL

30 hours of classroom training and 6 hours of behind-the-wheel training.

Price:

Credit Card

Card Details

Cardholder Name

This field is for validation purposes and should be left unchanged.