defensive driving course driving registration - Canadian Academy Of Defensive Driving

Defensive Driving Course Registration

Student's Information

Name

First

Last

Date of Birth

Gender

Phone Number

Alternate Phone

Total Number

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Emergency Information

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Relationship

Driver's License Information

Driver's License Number

License Class

Other explain

Expiry Date

Upload Front of License

Drag & Drop Files, Choose Files to Upload, or Capture With Your Camera

Upload Back of License

Drag & Drop Files, Choose Files to Upload

Course Purpose

What is the reason for taking this course?"

MEDICAL & SAFETY INFORMATION

Do you have any allergies, medical conditions, medications, physical limitations, or other health concerns the instructor should know about during in-vehicle training?"

Please describe

All medical and personal information provided is kept strictly confidential and is only shared with the assigned in-vehicle instructor for safety purposes while operating the vehicle.

SCHEDULING PREFERENCES

Preferred Training Days (Select all that apply.)

Weekdays (Monday–Friday)
Weekends (Saturday–Sunday)

Preferred Training Time (Select all that apply)

Morning (8:00 AM – 12:00 PM)
Afternoon (12:00 PM – 5:00 PM)
Evening (5:00 PM – 9:00 PM)

Preferred Instructor Gender

Preferred Language

Pickup Location for Driving Lessons

TERMS & CONDITIONS

Cancellation Policy

Cancellations with less than 24h notice may incur a fee. In-vehicle lessons cancelled with less than 12h notice charged in full.

Refund Policy

Full refunds within 7 days if no lessons started. Partial refunds prorated by completed hours.

Privacy Policy

Personal info collected for driver training only. Protected under Ontario privacy laws. Not sold or shared except as required by MTO or legal obligations.

Electronic Communication

Consent to receive emails and SMS for schedules, reminders, and school updates.

Checkboxes

I confirm that all information provided is accurate and complete. I have read and agree to the cancellation, refund, and privacy policies.

Checkboxes (copy)

I consent to electronic communication from Canadian Academy of Defensive Driving Inc. * Both must be checked before the "Continue to Payment" button is enabled.

Payment & Checkout

Total

$0.00

Stripe Credit Card