3601 South Highway 160 Pahrump, NV 89048

Toll Free 800.391.6891 ~ Direct 775.727.6363 ~ Facsimile 775.727.6366

www.RaceSpringMountain.com

Microsoft Word Reg. Form

~ Ideal for typing up and printing out to mail to us!

 Adobe Pdf Registration Form

~ Great for printing out to fax to us!

OR, FILL OUT THE ON LINE REGISTRATION FORM BELOW

Full Name:
  Name requested on Name Tag:
Address:
City:
State:
Zip:
Home#:
Business#:
Cell#:
Email:
Date of Birth (mm/dd/yy):
Are you proficient with manual transmission?:
Yes

No        
Request an Automatic :
Date and Program of First Choice School (Please specify level)

NOTICE: All deposits are NON-REFUNDABLE!

If a date change is necessary, a minimum of 30 day advanced notice must be given in order for the deposit to apply to the new date. If due notice is not given, the deposit shall be forfeited!
Prices For 2008 (Subject to Change)
NON-REFUNDABLE DEPOSIT ( required at booking)

Level One, 3 Day Program: $2995.00

Level Two, 2 Day Program: $2495.00

SCCA Licensing School: $2595.00

One Day Performance Highlights: $895.00

Level One: $1500.00

Level Two: $1300.00

Level S: $1300.00

One Day: $450.00

C6 Z06 Exclusive LV1-$995.00 / LV2-$1195.00 for the full duration of your school.

CRASH DAMAGE insurance is included in the prices above. This insurance covers all external damages after the first $8000.00 For level 1 and level 2 programs. You have an option to buy down the maximum liability of $8000.00. Performance Highlights insurance buy down is $50.00 with a maximum liability of $2000.00. Level 1 insurance buy down is $200.00 with a maximum liability of $2000.00. Level 2 buy down is $300.00 with a maximum liability of $2000.00.

Please Debit my VISA or MASTER CARD#:
Exp Date:
Balance is due 2 week prior to your school!
I hereby authorize Spring Mountain to run CC 2 weeks prior.

Yes

No        
Have you attended a driving school before?

Yes

No        
If so, where and when?
Will you have any food allergies,  or health needs while attending our school?
What Vehicle(s) do you currently own?
How did you hear about Spring Mountain Advanced Driving School?
Corvette Forum:
Z06.com:

Digital Corvettes:

Other Site:
C5 Registry:

Show/Event (Please specify)
Magazine (Please Specify) :
Friend (they receive a $100 discount in the future)
Other:
Emergency Contact Information:
Name:
Phone:
Relationship:
Is this a Surprise Gift for someone else?

Yes

No        

If this is a surprise, who shall we contact for questions?
Name:
Phone:
Email:
Mail Gift Certificate to:
Street(apt/box#):
City:
State:
Zip:
Would you like to pay the full tuition or the deposit?:
Full Tuition:
Deposit Only:
 
(See above for deposit/full tuition amounts)
Should confirmation be sent in a plain envelope?


Yes

No        
(No return address or logo on correspondence)
Sentiment request on Gift Certificate? i.e., “Happy Birthday”, “I Love You”, etc.
Which one of our representatives assisted you with questions, information, and booking?
   
CALL TOLL FREE NOW at 800.391.6891 to reserve your seat in the class!

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