Make Your Click4Life Pledge

Thank you for visiting the Delaware Safety Council’s
SmartDrive Click4Life Pledge Page.

We admire your commitment to safety by pledging to use seat belts –
whether passenger or driver – and always remembering to

BUCKLE UP – EVERY TRIP – EVERY TIME

Please fill in this pledge form completely.

SmartDrive Click For Life

Select Delaware High School
Drop down mneu to choose
Write In Your School Name Here if NOT LISTED
Your Name*
Please do not enter nicknames. Please include generational suffix like Jr., II, III, IV
First Last Jr/III etc.
Your Birthday*
Month
Day
Year
Your grade*
Drop down menu to choose
Email Address - HIGH SCHOOL STUDENTS ONLY
Please provide an email address for verification. >> If possible, do not use an address provided by your school - filtering software may block future messages from SmartDrive <<
Student Mobile Phone - HIGH SCHOOL STUDENTS ONLY
Enter your Parent's Name*
Enter the name of one of your parents or a guardian. The reason for this is SmartDrive has as a policy that we notify parents when we collect information from their children.
Mr/Mrs/Dr etc. First Last Sr/Jr/III etc.
Your Parent Email
Your pledge entry IS NOT valid with contact information for your parent - either an email address OR a mobile phone number is required.
Parent Mobile Phone Number - only use if your parent does not have an email address.
If your parent/guardian does not have an email account.

If you parent does not have an email address, please provide a mobile phone number.

When completing the pledge form – please do not use a school provided email address, as it typically blocks email from outside your school district.

Please do not enter your own email address as the parent email. It will make your pledge invalid.

SmartDrive has the responsibility to notify your parents of your interaction with us to comply with the Children’s Internet Protection Act (CIPA) when communicating with students in K-12 schools.