BDTAS Sign Up Form

Name *

First

Last

Date of Birth: *

Enter D.O.B in format: DD-MM-YYYY

GENDER: *

FEMALE
MALE

DRIVERS LICENCE / PERMIT NUMBER *

Are you comfortable driving a manual vehicle? *

YES
NO
Not Sure

Let us know if you can drive a manual car without assistance...

COURSE: *

Please select Course

ADDRESS: *

CONTACT NUMBERS: *

Please enter contact numbers separated by comma(,).

OCCUPATION *

Email *

Email

Confirm Email

PREFFERED START DATE: *

PREFFERED START TIME:

Comment or Message *

REASON FOR TAKING COURSE: *

DO YOU HAVE ANY MEDICAL CONDITIONS THAT WOULD HAMPER YOUR PARTICIPATION? *

YES
NO

IF YES, PLEASE EXPLAIN: *

WHAT WOULD YOU LIKE TO GAIN FROM THIS COURSE? *

I authorise Barbados Driver Training Advisory Services (BDTAS) to take, use and copy photographs and films of me at the Training Course without objection or charge including commercial use thereof. *

* I Agree
* I Disagree

*Photos and or Videos taken, may be used on our websites, social media pages and magazines for training or promotional purposes.

HOW DID YOU HEAR ABOUT US? *

Facebook
GOOGLE
Instagram
Radio Advert
Twitter
Word of Mouth
Work

DATE: *

By ticking this box you agree to be bound by our "Terms of Service" You will be required to Sign the Program Rules & Indemnity Waiver, in the presence of our staff. *

I Agree

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