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Pre-Registration - Critical Information

Please complete the following questions:
 
 

Student's given name:  First: A value is required.   Last: A value is required.

Parent or legal guardian e-mail address used to register: A value is required.Invalid format.

Critical Information!

Incomplete pre-registrations cannot reserve a spot, so be sure to complete the “Critical Information” thoroughly:

We pride our program in being the most personal program available in the U.S. And you’re about to find out why. This section helps us understand your student’s learning style so we can connect with your student on a level other programs cannot. Please share with us anything you feel may help us connect with your student and help them learn. Even things you may not suspect to be beneficial can help us: an accomplishment of which they’re proud, an embarrassing moment at which they can laugh, or even something personal about them of which YOU are very proud. And the more unusual, the more embarrassing, or the funnier, the better! You can avoid the typical “great kid” stuff we get from everyone … but better yet, here are some good examples from the past:, “Ran in to their Principal’s car at school”, “Loves to have his head scratched”, “Can imitate every Disney character”, “Got his head stuck in a shop-vac when he was 13”, “Falls down the stairs often”, “Has a cat named ‘Death from above’”, “Eagle Scout or Star Award” etc. DO NOT make the mistake of dismissing this as insignificant … to an educator, it’s the single-most important information you will provide.

Has your student had any crashes or traumatic experiences while driving? (Describe).


Has your student received any citations to date? If so, please provide details.


How’s their driving so far? And more importantly, WHY do you say so?


Does your student have any weakness(es) you would like us to address and/or reinforce for you in class. (Describe).


Does your student have any physical or emotional restrictions or limitations, including by not limited to, anything for which they have been clinically treated, or for which they take medication? If your student has such issues, please understand we can accommodate the majority of them, however, misrepresenting your student’s abilities can be grounds for dismissal from the program with no eligibility for refund Be candid in your reply with full confidence in our discretion.


Do they suffer from Deuteranopia, or any form of color blindness, and if so, which colors do they have difficulty distinguishing?


And please let us know for which, if any of these they take medication.
A value is required.

In what sports or extracurricular activities do they participate?


What musical instruments do they play, if any?


Do they have siblings and if so, where do they rank sequentially? (ex: Middle child of 3, only child, oldest of 4, etc.)


What subjects in school do they ENJOY the most? (Not necessarily that they EXCEL in … but ENJOY the most…)


Now the fun part: Give us some dirt on your kid! Tell us something funny, or better yet, embarrassing about your student! Of course, we use discretion, so no “Oh, they would kill me” replies will fly … just help us with anything that will help us connect with them and relate with them better, and therefore help them enjoy it more!)


Tell us about one of your students unusual accomplishments that is outstanding, impressive, admirable. (We already know your child is the straight-A, AP class, mission-trip going, kindest kid on the planet and everyone likes them. So now, rethink your answer to this question before you respond!).


Are they overly-sensitive about anything (i.e. being a nerd, being short or having Acne) or overly-enthusiastic about anything (i.e. Minnesota Vikings fan, New York Yankees fan, UGA fan)?


Complete the following sentence: “If my kid could just learn ONE THING from this program, I hope that one thing is … “
(Hint: Looking for an answer OTHER THAN “Drives too fast”, “follows too close”, “hugs the line”, “no cell-phone”, or “drives with one hand”, … they’re already a BIG part of the program.)



Terms and Conditions:

Within a few days of completing your complete all sections of the pre-registration, you will then receive confirmation of the driving session in which you were placed, or a sold-out notification. Be absolutely certain your computer is set up to receive e-mails from Homer@AccidentAvoidanceWorkshops.org. All future communications, which make up about 40% of the program, will come from this address. You will be required to sign a waiver/release in order to participate in both the classroom session and the driving session.

Please make a selection.
I have read, understand, and will adhere to the above terms and conditions.”

Your financial commitment: You have 24 hours from submitting your pre-registration to cancel, and must request cancellation by e-mail only for documentation purposes. Your attendance is committed after that, no exceptions. Should you encounter a medical or family emergency later, you may send another qualified family to attend in your stead. Simply notify us by e-mail no later than 18 hours in advance, and have them arrive at the scheduled classroom session, and we will be prepared to accommodate them. Base tuition includes both parents for the classroom. $60 in cash paid on the driving day will admit a second parent. Only those who complete the entire program will be entitled to the benefits for doing so.

Please make a selection.

To submit, click the button below.
~ If submitted complete, the next screen will read, ”Thank you for your PRE-Registration"
~ If not, scroll up and complete any sections showing as incomplete, and try again.