Designated Driving Services
Teen Contract To Family Members

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Five (5) Simple Steps To Submit Form:
1.) Complete Contract ageement and donation information.
2.) Click 'Print Page' to print your completed contracts.
3.) Click 'Submit' button. (This will allow us to print and mail or deliver contracts to those that do not have a printer available. It your choice!)
4.) Sign your contracts and mail in with your donation.
5.) Designated Driving Services will contact you by phone or email to confirm that we received your contracts and donation. You will then have an option to have ALL your cards sent by mail or delivered by a Designated Driving Services staff member. It's just that simple!

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DDS Teen Contract Agreement Form

I recognize as a young teen that there are many potentially dangerous decisions I may encounter everyday but I will do everything in my power to avoid making the wrong decision that will jeopardize my health, my safety and your trust in me. I understand the dangers associated with the use of alcohol, drugs, reckless driving and the destructive behaviors often associated with impairment and reckless driving. I will read and discuss each rule of this contract with my family.

1. Teen Agrees To the following "no alcohol" rules:
I will not stay at parties where alcohol is being served.
I will not ride in a car with a driver who has been drinking.
I will call a parent/guardian or use my DDS card for a ride home if my driver is impaired.
I will call a parent/guardian or DDS for a ride home if my date is making me uncomfortable.
I will not allow my friends to bring alcohol into my house or onto my property.
I will not be succumb to peer pressure by drinking alcohol.

I have read and discussed each alcohol rule above with my family members. By signing below, I promise my family and DDS to honor all the rules. If I break any of these alcohol rules, I will accept the consequences, which are:

Teen Signature: ____________________________________ Date: _______

2. Teen Agrees To the following driving safe rules:
I will not use a cell phone while driving
I will not send or read text messages while driving
I will not play loud music while driving
I will not eat or drink while driving.
I will wear my seatbelt at all times
I will make sure my passengers wear their seatbelts at all times in the vehicle
I will always obey the posted speed limit

I have read and discussed each driving safe rule above with my Parents/Guardians. By signing below, I promise my Parents/Guardians to honor all the rules. If I break any of these driving safe rules, I will accept the consequences which are:

Teen Signature: ____________________________________ Date: _______

Important Note: Designated Driving Services is Not A Taxi service! We are to be used in emergency situations only! If Designated Driving Services feel that you are abusing our services or put our drivers in harms way at anytime, we will deactivate your Contract and Transportation Cards Immediately!

By signing this contract below, I promise to abide by all of the rules mentioned. I agree to communicate with my parents/guardians regularly about issues of importance to both of us. All discussions will promote mutual respect. Even if we don't agree, we will be respectful and not raise our voices when speaking. We will keep communication channels open at all times.

Teen Signature: _____________________________________ Date: _________

Parents/Guardians Signature: __________________________ Date: _________

DDS Witness: ______________________________________ Date: _________

Donation Information: [Must Complete]

Name

Address:

City: Zip: County:

Phone: E-mail:

How did you hear about Contract Program!

Representative: If "other" describe here:

Check or Money Order Donation: $ Payable To: Designated Driving Services

Total Donation Amount: $

Please Do Not Send Cash!

Please Mail All Checks/Donations and Signed Contracts To:
Designated Driving Services * P.O. Box 1571 * Horsham, PA 19044-2044

Before clicking "Submit" button! Click "Print Page" below and sign contracts and send to address above.

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