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My Driver Safety Agreement

Driving is a privilege that I may lose by violating this agreement. This privilege may be suspended for other reasons such as (but not limited to) unsatisfactory school grades and violations of family trust.

I will obey any curfews or restrictions imposed by my driver's license.

I will obey all traffic laws and speed limits.

I will not drink and drive, or use illegal drugs, or drive if I am taking ANY medication that may affect my driving.

I will not ride with anyone whom I know or suspect is under the influence of alcohol or drugs (legal, or illegal).

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.

I will not ride in any vehicle where I know 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 any weapon.

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 make certain that I can always hear emergency vehicles and traffic sounds.

I will drive defensively.

I will avoid being a distracted driver, particularly avoiding texting or operating a cell or smartphone.

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. While 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, fog, unlit roads, 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.

Additional Conditions Required By My Parent(s):



I have read, understood and I will comply with this agreement.

Signed______________________ Witnessed_________________________


COPYRIGHT: Insurance Publishing Plus, Inc. 2017

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.


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125 W La Cadena Dr. Suite B | Riverside, CA 92501 | Phone: 951-684-3500 | Fax: 951-684-3578 | tim@ria-cb.com

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