Youthful Operator Driver Safety
Agreement
My Driver Safety Agreement
I, the undersigned, agree to the following
conditions and restrictions as they relate to the privilege of
operating any motor vehicle, motorcycle or recreational
vehicle including watercraft.
I understand that driving is a privilege and
that I may lose this privilege by violating any of the articles
contained in this agreement. I also understand that my driving
privileges may be suspended for other circumstances such as (but
not limited to) unsatisfactory school grades, violations of family
trust, and other infractions.
- I will obey any curfews or restrictions
imposed by my driver's license.
- I will obey all traffic laws.
- I will not speed.
- I will not drink and drive, or use illegal
drugs, or drive if I am taking ANY medication that may impair
my driving abilities. Nor will I ride with anyone whom I know
or suspect is under the influence of alcohol, drugs (legal, or
illegal), that may impair driving abilities.
- 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.
- 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).
- 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.
- 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.
- I will drive defensively, recognizing the
driving dangers posed by other drivers.
- As a driver, I will not transport passengers
unless they are properly secured by a seatbelt.
- I will always wear a helmet if I am driving
or riding on a motorcycle. I will not transport a passenger unless
he or she also wears a helmet.
- I will drive in a manner that respects
the safety of myself, my passengers, other drivers and pedestrians.
- I will ignore peer pressure. When I am
driving, I am in control. I can stop and ask others to leave my
vehicle and, as a passenger, I can ask a driver to stop and let
me out.
- I will not drive unless I feel safe and
certain of my ability.
- I will be especially alert during dangerous
conditions such as rain, snow, sleet, wind, heavy traffic, construction
zones, and accident scenes.
- I will always lock every door and take
the keys when I leave the vehicle. I will park in areas where
I believe the vehicle will be safe from damage or theft.
- I will obey the driving instructions of
my parent(s) and of law enforcement officers.
- 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.
Additional Conditions Required By My Parent(s)
- ________________________________________________________________________________
- ________________________________________________________________________________
- ________________________________________________________________________________
- ________________________________________________________________________________
I have read and understood this agreement.
Signed____________________________
Date:_____________________________
Witnessed_________________________
Revised: 11/98
410f002a
COPYRIGHT: Insurance Publishing Plus,
Inc. 1996
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