1 Stop Better Driving School
27821 W 7 mile rd
Livonia MI 48152
(313) 740-7995 www.1stopbetterdrivingschool.com
Office Hours: Monday – Friday, 9:00 am – 3:00 p.m. Department of State Certification # P000499
SEGMENT 1 CONTRACT
Program Number #_____________ Classroom Location:___________________________________________
Dates of Class________________________________________________
Student________________________________________________________ ________ _______________
Name Last First Middle Age Date of Birth
Address __________________________________________ City________________________ Zip ____________
Home Phone ___________________________ Work Phone (Parent or Guardian) __________________________
Parent’s Name___________________________ Home Phone (Parent)___________________________________
Address __________________________________________ City________________________ Zip ____________
COURSE PROVISIONS
1. 1 Stop Better Driving School will provide a minimum of 24 hours of classroom instruction, 6 hours of behind-the-
wheel (BTW) instruction, and 4 hours of observation time in a dual controlled automobile, fully insured, covering each
student enrolled in the program. Classroom instruction must be a minimum of 3 weeks in length. BTW instruction shall
not begin until the student has received a minimum of 4 hours of classroom instruction. BTW instruction must be
completed no later than 3 weeks after the classroom instruction has been completed. The state exam will be taken the
day before the last day of class. Retakes will be taken with a alternate test on the last day of class, exams can be
given orally with notice.
REQUIRED LANGUAGE
NOTICE - This provider is required to be certified by the Secretary of State. If you have any complaint, which you
cannot settle with this provider, write: Michigan Department of State, Driver Programs Division, Lansing, MI 48918.
Completion of driver education instruction does not guarantee qualification for a driver license.
TERMS
1. The student must be at least 14 years/8 months of age by the first scheduled day of class (verification by birth
certificate required).
2. The parent or guardian agrees to pay the amount of $405.00.
Payment methods are cash, check or cashapp, cash only after 1st week of class.
Replacement certificate fee $25.00. Returned check fee $40.00.
3. Requirements to pass the course:
a. Attend 24 hours classroom training completing all assignments.
b. Have 6 hours of behind-the-wheel instruction and at least 4 hours of observation time.
c. All students must take the Michigan State Exam at the end of the class and score at least 70%.
d. Meet physical and mental requirements of the Michigan Vehicle Code, or have physician statement
allowing attendance.
e. Adhere to all school rules and instructions regarding behavior in the classroom and behind-the-wheel.
4. The required cost of materials and supplies for the class are provided. Lost or damaged book fee is $40.00. “AAA
How to Drive Education Manuel”. No charge for returned undamaged books.
5. In the event of a unexcused driving appointment cancellation, a cancellation fee of $25.00 will be charged.
6. In case of a student’s absence or emergency the school’s policy will be to make up classes missed.
The make-up day policy will be to complete the missed class/classes when a Segment 1 class is offered depending on
space limitations of the class.
REFUND POLICY
1. If for any reason you decide to withdraw from the course before its completion, your refund will need to be in
writing and are to be based on the following:
a. A full refund will be issued prior to the start of class.
b. A partial refund through the first week of class will be deducted at the rate of $40.00 per day for classroom and
behind the wheel drive fee will be an additional $35.00 per drive.
c. No refunds will be issued due to student disciplinary actions.
d. Refunds after the first week of class will not be issued.
________________________________________________ _____________________________________
Student Signature Parent or Guardian Signature
_______________________________________________ _____________________________________
School Representative Signature Date of Contract
BEHIND-THE-WHEEL INSTRUCTION AGREEMENT
Parent waiver agreement for INDIVIDUAL on-the-road instruction.
By signing below I, _____________________________, authorize 1 Stop Better Driving School
to allow a certified instructor employed by the provider to offer my child on-the-road driving
instruction without another passenger in the in the vehicle.
___________________________________ ___________________
Signature of Parent or Guardian Date
___________________________________
Signature of Provider
RELEASE, WAIVER AND INDEMNIFICATION
The undersigned participant and his/her parent or legal guardian does hereby execute this release, waiver and
indemnification for him/her, his/her heirs, successors, representatives and assigns: and hereby agrees and represents
as follows:
To release 1 STOP BETTER DRIVING SCHOOL, all employees, representatives and affiliates with this course from
any and all liability, loss, damage, costs, claims, and/or causes of action, including but not limited to all bodily injuries
and property damage arising out of participation in 1 STOP BETTER DRIVING SCHOOL driver education course. It is
being specifically understood that the program includes the operation and use by the undersigned participant and
others of automobiles. The undersigned further agrees to indemnify 1 STOP BETTER DRIVING SCHOOL, all
employees, representatives and affiliates with this course, and hold them harmless for any liability, loss, damage,
costs, claim, judgment or settlement which may be brought or entered against them as a result of the undersigned
participation in said course. This indemnification shall include attorney’s fees incurred in defending against any claim
or judgment and incurred in negotiating any settlement. It is understood and agreed that the undersigned shall have
the opportunity to consent to any such settlement, provided, however, that such consent shall not be unreasonably
withheld.
_____________________________________________________ ____________________
Signature of Parent or legal guardian Date
_____________________________________________________ ____________________
Signature of Student Date
_____________________________________________________ ____________________
Signature of School Representative Date
1 STOP BETTER DRIVING SCHOOL 27821 W 7 Mile rd. • Livonia • MI • 48152 • (313) 740-7995 Department of State Certification # P000499 • Office Hours: Monday – Friday, 9:00 a.m. – 5:00 p.m. Program Number #: TEEN SEGMENT 1 REGISTRATION FORM Classroom Location:
________________________________________
PLEASE PRINT
Student: (Last) (First) (Middle)
Address: City: Zip:
Home Phone: Age: D.O.B.:
Parent/Legal Guardian’s Name: Parent/Legal Guardian’s Phone #:
Emergency Contact: Phone #:
ACCOMMODATIONS/MEDICAL CONDITIONS
1. Does the student require any special accommodations to participate in the classroom phase (i.e., test being read, interpreter, eating arrangements, etc.)? Yes No If Yes, please explain:
2. Does the student require any special accommodations to participate in the behind-the-wheel phase (i.e., adaptive devices, an interpreter, etc.)? Yes No If Yes, please explain:
3. Is the student taking any medications that may affect his/her ability to drive a motor vehicle safely? Yes No If Yes, please explain:
4. Are there any medical conditions that would pose a concern with the student’s behind-the-wheel instruction (i.e., epilepsy, asthma, color blindness, hearing loss)? Yes No If Yes, please explain:
5. Is the student’s visual acuity at least 20/40 corrected? Yes No
6. In the last six months, has the student had a fainting spell, blackout, seizure, or other uncontrolled loss of consciousness? Yes No
7. In the last six months, has the student had a physical or mental condition which would affect his/her ability to drive a motor vehicle safely? Yes No
If the answer to any of questions 5 – 7 is Yes, then the Parent/Guardian must provide a letter signed by the Student’s physician indicating that the condition has been corrected and/or is under control and the Student meets the physical and mental requirements for a motor vehicle operator’s license under Section 309 of the Michigan Vehicle Code, 1949 PA 300, MCL 257.309.
CERTIFICATION: I certify that all information contained within this document is true and accurate to the best of my knowledge.
Date: Student Signature:
Date: Parent/Legal Guardian Signature:
Date: By: Provider Name Signature of Provider Owner (Title)