Call Us Have any questions? | 618.997.1311
Auto Insurance AUTO Read More
Homeowners Insurance HOME Read More
Business Insurance BUSINESS Read More
Life & Health LIFE & HEALTH Read More
Additional Quotes ADDITIONAL QUOTES Read More
Senior Products SENIOR PRODUCTS Read More

Parent/Teen Driving Agreement

Provided by: The Insurance House


I, ____________________________, will drive carefully and cautiously and will be courteous to other drivers, bicyclists, and pedestrians at all times.

I promise that I will obey all the rules of the road.

  • Always wear a seat belt and make all my passengers buckle up
  • Obey all traffic lights, stop signs, other street signs, and road markings
  • Stay within the speed limit and drive safely
  • Never use the car to race or to try to impress others
  • Never give rides to hitchhikers

I promise that I will make sure I can stay focused on driving.

  • Drive with both hands on the wheel
  • Never eat, drink, or use a cell phone to talk or text while I drive
  • Drive only when I am alert and in emotional control
  • Call my parents for a ride home if I am impaired in any way that interferes with my ability to drive safely
  • Never use headphones to listen to music on an mp3 player or other electronic device while I drive

I promise that I will respect laws about drugs and alcohol.

  • Drive only when I am alcohol and drug free
  • Never allow any alcohol or illegal drugs in the car
  • Never accept a ride if the driver is not also alcohol and drug free

I promise that I will be a responsible driver.

  • Drive only when I have permission to use the car and will not let anyone else drive the car unless I have permission
  • Drive someone else's car only if I have parental permission
  • Pay for all traffic citations or parking tickets
  • Complete my family responsibilities and maintain good grades at school as listed here: ____________________________________________________
  • Contribute to the costs of gasoline, maintenance, and insurance as listed here: ____________________________________________________

Additional Promises:



I agree to the following restrictions, but understand that these restrictions will be modified by my parents as I get more driving experience and demonstrate that I am a responsible driver.

  • For the next _____ months, I will not drive after ________ pm.
  • For the next _____ months, I will not transport more than _______ teen passengers (unless I am supervised by a responsible adult).
  • For the next _____ months, I won't adjust the stereo, air conditioning/heater or any electronic devices while the car is moving.
  • For the next _____ months, I will not drive in bad weather.
  • I understand that I am not permitted to drive to off-limit locations or on roads and highways as listed here: ________________________________________________________________
  • Additional restrictions:



Penalties for contract violations:

  • Drove after drinking alcohol or using drugs

No driving for ___ months.

  • Got ticket for speeding or moving violation

No driving for ___ months.

  • Drove after night driving curfew

No driving for ___ weeks/months

  • Drove too many passengers

No driving for ___ weeks/months

  • Broke promise about seat belts (self and others)

No driving for ___ weeks/months

  • Drove on a road or to an area that is off-limits

No driving for ___ weeks/months


I agree to follow all the rules and restrictions in this contract. I understand that my parents will impose penalties including removal of my driving privileges, if I violate the contract. I also understand that my parents will allow me greater driving privileges as I become more experienced and as I demonstrate that I am always a safe and responsible driver.



Driver: ______________________________________________     Date ________________

Parent promise: I also agree to drive safely and to be an excellent role model.

Parent (or guardian): ___________________________________    Date ________________

Parent (or guardian): ___________________________________    Date ________________


2014 Zywave Inc. All Rights Reserved.

Posted 12:35 PM

Share |

No Comments

Post a Comment
Required (Not Displayed)

All comments are moderated and stripped of HTML.
Submission Validation
Change the CAPTCHA codeSpeak the CAPTCHA code
Enter the Validation Code from above.
NOTICE: This blog and website are made available by the publisher for educational and informational purposes only. It is not be used as a substitute for competent insurance, legal, or tax advice from a licensed professional in your state. By using this blog site you understand that there is no broker client relationship between you and the blog and website publisher.
Blog Archive

View Mobile Version
© Copyright. All rights reserved.
Powered by Insurance Website Builder