Header

Youth Driver Training / Certification Program Application


Date:

Applicant Information 

Name: Age:  

Address:  

City: State: Zip:  

EDGE&TA Branch #:  Phone #:

Parent / Sponsor Name:


Test # 1
 

Instructor:  

Test # 2 

Instructor:  

Test # 3 

Instructor:  

Test # 4

Instructor:  

Approved for Parade Tractor Pull

 Make & Model of Tractor:  
If the youth qualifies on more than -1- tractor, add them to list.

I understand my child will be operating a tractor/motorized vehicle at EDGE&TA
shows and parades and will be responsible for his/her activities.

Signature (Parent or Sponsor):  

Mail the card to:

Address:  

City: State: Zip:  

Phone #: E-mail Address: 

EDGE&TA Branch #


(All cards will be mailed to the return address unless requested otherwise). Revised: August 7, 2014
Mail form to: Don Young, National Safety Director
P.O. Box 635
Pearblossom, CA 93553
e-mail: donsredtractor@hotmail.com