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Defensive Driving Online Registration

Dallas Hiram Defensive Driving Registration Form

The State of Georgia is now allowing students to take courses remotely from home! If you plan on completing your course remotely, there are certain guidelines you need to know:

1. You must use a device with a camera & microphone. Apple iPhones, Android phones, Laptop computers, desktop computers with webcams, are all acceptable as long as the camera & microphone is functional. Keep your device plugged in!
2. Remote classes require the usage of a third-party app. Please check your App Store for the WebEx Meetings App or download for your computer here: https://www.webex.com/downloads/

Student Information

Enter the information below as it would appear on the students drivers license!
Name(Required)
MM slash DD slash YYYY
Address(Required)
Attach a copy of a Photo ID. You can also e-mail a copy to staff@dallashiramduischool.com. You can scan it in or take a clear photo with your smartphone camera.
Max. file size: 64 MB.

State Approved Defensive Driving Class

A defensive driving class can be taken for a variety of reasons. Be sure to indicate why you are taking the class below.
Your reason for taking the course:(Required)
If you are unsure why you are taking the defensive driving class feel free to give the school office a call at 770-443-1644 and we can help!
I prefer to take my class by(Required)
Course dates are not final until you are contacted by our staff. We do our best to accommodate last minute registrations.(Required)

Defensive Driving (Driver Improvement) Terms of Agreement

I, the undersigned student, agree to complete the above course, consisting of 2 classes for 3 hours each, totaling 6 hours of instruction by the above-name driver improvement clinic. It is understood that this Clinic is certified by the Georgia Department of Driver Services (DDS) in accordance with Georgia Law Title §40-5-80 (DRIVER IMPROVEMENT ACT) and the rules and regulations adopted there under and that each instructor is certified by the DDS. This course is approved by the DDS.

The student's successful completion of the above-named course requires each of the following:

1. Attendance at all classes sober and free from illicit drugs.
2. Attendance on time for all sessions.
3. Reasonable attentiveness and participation in all classes.
4. Attendance at all sessions unless medically excused.
5. All sessions must be completed within 60 days.
6. Successfully passing a written or oral examination with a grade of at least 70.

This driver improvement clinic will not refund any tuition or part of tuition if the Clinic is ready, willing, and able to fulfill its part of this contract. I understand that if I fail to comply with the terms and conditions of this agreement, I am in breach of contract and the school will not be under any obligation to fulfill the terms of this contract, and may, at its option, terminate this agreement immediately.

It is agreed that an owner, instructor, or employee of this Clinic shall not give the impression to a student that upon completion of their instruction this Clinic will guarantee the securing of a driver's license to operate a motor vehicle. However, immediately upon the student's successful completion of the course as described above, the Clinic agrees to provide certification of said completion to the student.

This Clinic has and will maintain for the protection of the contractual rights of the student a performance bond in the principal sum of ten thousand ($10,000.00) dollars for the students to be written by a company authorized to do business in the state of Georgia.

This agreement constitutes the contract between the above-named driver improvement clinic and the above-named student and no verbal statements will be recognized.
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Payment Information

Credit Card(Required)
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Expiration Date
 
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