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June 11, 2026

Student’s Name:

I understand the health risks associated with participating in driving lessons due to COVID - 19 and I give permission for my child to participate.

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Signature Certificate

Participant Screening for Behind the Wheel Lessons - Under 18

Unique Document ID: 5476bd6f571b490d975af146b7cc36426c73a14b

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Timestamp

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October 2, 2020 3:30 pm EDT

Participant Screening for Behind the Wheel Lessons - Under 18 Uploaded by Premier Driving School, Inc - service@premierdriversed.com IP 73.212.178.216