My Driver Safety Agreement

I the undersigned do hereby agree to the following conditions and restrictions as they pertain to the privilege of driving any motor vehicle, motorcycle or recreation vehicle including watercraft.

I understand that driving is a privilege and not a right; that removal of my driving privileges can result from violations of any of the articles contained in this agreement; and that the privilege of driving may be suspended for conditions not related to my driving skills e.g. less than satisfactory school grades, violations of family trust, and other infractions that require restrictions upon my freedom.

1. I will obey any curfews or restrictions that my driver's license imposes.
2. I will obey all traffic laws.
3. I will not speed.
4. I will not drink and drive, or use illegal drugs, or drive if I am taking prescription or over-the-counter drugs that may impair my driving abilities. Nor will I ride with anyone whom I know or suspect is intoxicated or who may be under the influence of drugs, legal, or illegal that may impair driving abilities.
5. I will not permit any open or empty containers of alcohol, or transport anyone who I know or suspect may be carrying illegal drugs in any vehicle I operate, nor will I ride in any vehicle where I know that there are empty or open containers of alcohol or where anyone who I know or suspect may be carrying illegal drugs.
6. I agree not to drive with or transport anyone who is in possession of a firearm or other "weapon" without the permission of my parent(s).
7. I will always wear my seatbelt and shoulder harness. I will not ride in any vehicle in which there are more people than seat belts.
8. I will keep the radio, stereo, CD or tape deck at a reasonable volume so that I can still hear fire, police and ambulance sirens and other traffic sounds.
9. I will drive defensively and understand that the other driver may not be paying attention or operating his or her vehicle in the manner that I expect.
10. If I am driving in a pickup truck, van, truck or car, I will permit no one to ride anywhere other than in a seat where a seatbelt is provided.
11. I will always wear a helmet if I am driving or riding on a motorcycle. I will permit no one to ride on the motorcycle I am driving who does not also wear a helmet.
12. At all times I will drive as if my life and my passengers' lives depended upon it. I understand that I am 100% responsible for my actions or inaction while driving any vehicle.
13. I will not succumb to peer pressure. When I am driving, I am in control. I can stop and ask others to leave my vehicle. I can ask the other driver to stop and let me off.
14. I will not drive in situations beyond where I feel safe or where I am unsure of my ability.
15. I understand that rain, snow, sleet, wind, city traffic, commuting hours, construction zones, and accident areas are all very dangerous conditions and I must be especially alert during these times.
16. I will always lock every door and take the keys when I leave the vehicle. I will not park in areas where I am unsure that the car will be safe from damage or theft.
17. I will obey the driving instructions of my parent(s) and of law enforcement officers.
18. If I want to race any vehicle, I must first obtain the permission of my parent(s), become properly trained and licensed, and confine these activities to sanctioned racing events and racing circuits.
19. I understand that all of these rules also apply to any other motor vehicle, recreational vehicle or boat I may operate or travel on or in.

Other Special Conditions Required By My Parent(s)

• ___________________________________________
• ___________________________________________
• ___________________________________________
• ___________________________________________
• ___________________________________________

I have read the agreement, it has been explained to me, and I understand it.

Signed____________________________

Date:_____________________________

Witnessed_________________________

© Insurance Publishing Plus, Inc. 1996, 2002. All rights reserved.
Production or distribution, whether in whole or in part, in any form of media or language; and no matter what country, state or territory, is expressly forbidden without written consent of Insurance Publishing Plus, Inc.