Better Ohio Teen Drivers Inc.

Student's Information

First Name

Last Name

Student's Contact Information

Phone Number

Email Address

Student's Home Address

Street Address

City

State

Zip Code

Emergency Contact Information (Use Parent/Guardian If A Minor)

Emergency Contact Name

Emergency Phone Number

Emergency Email Address

**Choose A Preferred Date Of Enrollment & Two Alternates* (View Upcoming Dates)**

Preferred Date

First Alternate Date

Second Alternate Date

*BOTD reserves the right to combine enrollments for scheduling purposes.

Vehicle Information

Year

Make

Model

Mileage

Payment Information - Visa or MasterCard Only

Credit Card Number

Expiration Date (mmyy)

CVV Code (Help Locate My CVV Code)

Total Amount Due

Promo Code (If Applicable)

Credit Card Holder Information (Address MUST MATCH Credit Card Billing Address)

First Name

Last Name

Street Address

City

State

Zip Code

Phone Number

Email Address

Enrollment Terms & Conditions

Better Ohio Teen Drivers, Inc., hereafter referred to as "BOTD", agrees to provide advanced driver training through its Car Control Drills Program, hereafter referred to as “CCD Program” to the "Student" enrolled through the BOTD Online Enrollment Form found at: betterohioteendrivers.org/bsdd_sign_up.asp

The base tuition for the BOTD CCD Program is $395.00 payable by credit/debit card via an online enrollment. Enrollments at a discounted tuition and/or other forms of payment may be allowed and/or arranged at the discretion of BOTD.

BOTD’s enrollment, cancellation and refund policy can be found at: betterohioteendrivers.org/course-sign-up.php

The CCD Program description and hours can be found at: betterohioteendrivers.org/car-control-drills.php

The Student agrees to observe and obey any and all rules, warnings, instructions or directions given by BOTD instructors, staff, representatives or agents. Any Student (and/or parent) exhibiting inappropriate, unruly or disrespectful behavior will be escorted out of the CCD Program immediately.

The Parent/Guardian of the Student and the Student agree to assume full responsibility for, and indemnifies and holds BOTD, its staff and any associated entities, including but not limited to any facility owners/landlords, harmless from and against any and all liabilities, damages (including, without limitation, bodily injury or death), losses, costs and expenses (including, without limitation, reasonable attorneys’ fees) arising out of or in connection with the Student’s participation in the CCD Program whether caused by the negligence of BOTD, its staff and any associated entities or otherwise.

The Parent/Guardian of the Student and the Student agree to assume full responsibility for any and all damages to any property, equipment or automobile provided by BOTD, arising within the scope of permitted, supervised training activities in amounts up to but not exceeding $1,000 regardless of the nature or cause of such damages. The Parent/Guardian of the Student and the Student further agree to promptly reimburse BOTD for such damages upon demand or, in the alternative, to authorize BOTD to charge either the Parent/Guardian’s or the Student’s credit/debit card in amounts up to but not exceeding $1,000 regardless of the nature or cause of such damages.

The Parent/Guardian and the Student agree that the Student will participate in the CCD Program in a vehicle that is driven frequently, has no significant mechanical issues and can be driven safely in difficult car control situations.

BOTD strongly recommends an ASE Certified mechanic inspect any vehicle 15 years or older and/or with mileage higher than 150,000 miles. BOTD reserves the right to disallow any vehicle deemed unsafe for use in the CCD Program.

The BOTD CCD Program CANNOT accommodate a FULL-size pickup truck, FULL-size SUV or FULL-size van. Please do not enroll with the intention of using one of these vehicles.

The Parent/Guardian and the Student agree that both the Student and the Student’s vehicle are currently insured at levels that meet State of Ohio minimum insurance coverage requirements.

The Parent/Guardian and the Student agree that the Student has a current license, temporary permit or court-approved driving privileges.

The Student will attend the CCD Program in attire that is consistent with local public high school dress code policies. The Student will wear closed-toe shoes that fasten securely to the feet. ABSOLUTELY NO sandals, flip-flops, pool shoes, etc. are permitted to be worn during the CCD Program.

In the event of an emergency and reasonable attempts to contact the Emergency Contact provided on the Online Enrollment Form are unsuccessful, the staff of BOTD is authorized to consent to any medical treatment or care deemed advisable by a licensed medical practitioner in the best interests of The Student.

The Parent/Guardian and the Student authorize BOTD to use the Student’s photographic likeness in any format or media for advertising, marketing, trade or any other lawful purpose.

I have read, understand, and agree with the above terms of the BOTD waiver

Online Enrollment Form (All Fields Are Required)

Student's Information

Student's Contact Information

Student's Home Address

Emergency Contact Information (Use Parent/Guardian If A Minor)

**Choose A Preferred Date Of Enrollment & Two Alternates* (View Upcoming Dates)**

*BOTD reserves the right to combine enrollments for scheduling purposes.

Vehicle Information

Payment Information - Visa or MasterCard Only

Promo Code (If Applicable)

Credit Card Holder Information (Address MUST MATCH Credit Card Billing Address)

Enrollment Terms & Conditions

Focus, Awareness, Tires & Eyes - Your FATE is in your hands and totally under your control nearly 100% of the time!