Traffic Safety Is a Team Sport

Name (First, Last Initial)

First Name Last Initial

Choose Your Age Group

Under 16 16 - 18 19 - 21 21 - 30 31 - 65 66+

High School Grade (If Applicable)

9th Grade 10th Grade 11th Grade 12th Grade N/A

School, Town, State

Example: Peoples Academy, Morristown, VT

Traffic Safety Pledge // Check All That Apply: "I am committed to the following..."

I promise to ALWAYS wear my seatbelt. I promise to speak up when I am a passenger, making sure everyone in the car wears their seatbelt. I understand that during my first three months of operation with a Junior Driver’s License, I must drive alone OR with at least one (1) front seat passenger who is a licensed and unimpaired parent or guardian OR driver education instructor OR individual 25 years of age or older. During my second three months of operation under a Junior Driver’s License, I may begin transporting family members. After holding a Junior Driver’s License for six months, there are not restrictions. However, I am never allowed to transport more passengers than there are safety belts. I promise to turn off portable electronic devices and put them out of reach before starting to drive. I promise to speak up when I am a passenger and my driver uses a portable electronic device while driving. I understand that there are times when it’s OK to chase speed and adrenaline—but that time is not when we get behind the wheel and hit the road. When driving, I promise to take my time, and take care of others.

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Traffic Safety is a Team Sport