SUNY Broome Community College's
Driver Education Program
Parent - Student Driving Agreement
Read and Sign
Student Segment:
As of ____________ (today’s date), I ____________________________ (teen’s name) am aware of my privileges and responsibilities as a licensed driver in this state. As a result, I will use my Broome Community College learning experience and my personal abilities to become a safer, more defensive driver. Furthermore, I agree to all of the following conditions:
Parent Segment:
As of ________________ (today’s date), I _______________________________ (parent/guardian’s name) am aware of my
responsibilities as the parent/guardian of a licensed teenage driver in this state.
As a result, I will agree to be an effective coach and counselor for my teen driver, and participate actively in his/her growth as a safe and defensive driver.
Furthermore, I agree to all of the following conditions:
Add your personal agreements here:
SIGNED:
__________________________________________
Teen Date
__________________________________________
Parent/Guardian Date
Thanks to Toyota Driver Safety Program Material
As of ____________ (today’s date), I ____________________________ (teen’s name) am aware of my privileges and responsibilities as a licensed driver in this state. As a result, I will use my Broome Community College learning experience and my personal abilities to become a safer, more defensive driver. Furthermore, I agree to all of the following conditions:
- I will always wear a safety belt, and insist that any passengers in my vehicle do as well. If I violate this condition, I understand that my driving privileges may be revoked for a period of ________________________________________.
- I will never drink or use drugs and then drive a vehicle; I will also never ride in a vehicle being driven by someone who is impaired by alcohol or drugs. If I violate this condition, I understand that my driving privileges may be revoked for a period of _______________________________________.
- I will obey ALL traffic laws, including state-mandated curfews and passenger limitations.
- I will maintain a clean driving record, with no traffic violations or crashes; I further understand violations may result in my parents revoking my driving privileges for a period of __________________________________.
- I agree to pay for all tickets and violations I incur.
- I will have no more than _______ passengers at any one time, unless specifically approved by my parent/guardian.
- I agree to drive only between the hours of _______ and _______, unless returning from work- or school-related activities, or with the specific permission of my parent/guardian.
- I will call and check in.
- I will not use a cell phone, email or text while driving.
- If I am driving and one of my friends refuses to wear a safety belt, I will ______________.
- If I am driving and my friends all want to drive with me but there’s not enough room for everyone, I will _____________________.
Parent Segment:
As of ________________ (today’s date), I _______________________________ (parent/guardian’s name) am aware of my
responsibilities as the parent/guardian of a licensed teenage driver in this state.
As a result, I will agree to be an effective coach and counselor for my teen driver, and participate actively in his/her growth as a safe and defensive driver.
Furthermore, I agree to all of the following conditions:
- I will supervise the learning and development of my son/daughter as a safe, defensive driver.
- I will require that my teenager, ___________________________, obey all of the conditions listed in this agreement.
- I will exercise patience, care, and understanding in my duty as the responsible parent/guardian of a teenage driver.
- I will be a good role model for my teenager.
- I will not use a cell phone, email or text while driving.
- I will obey all traffic laws.
- I will never drink or use drugs and then drive a vehicle; I will also never ride in a vehicle being driven by someone who is impaired by alcohol or drugs.
Add your personal agreements here:
SIGNED:
__________________________________________
Teen Date
__________________________________________
Parent/Guardian Date
Thanks to Toyota Driver Safety Program Material