Parent / Teen Contract

This contract is an agreement by and between ____________________, hereinafter referred to as ____________________ and ____________________, hereinafter referred to as ____________________ on the ____ day of _____________, in the year ________.

Teens 

A.    I will be changing my lifestyle of negative behavior and bad habits. To accomplish this, I will need the support of my family and peers. I understand that I am part of a family, a community and of a society. I understand that there are certain personal responsibilities that come with being a part of this family, community and society. I will agree to and abide by the following rules:

1.)  I will inform my parents:

a.    Where I am going and get permission.

b.    Who is providing my transportation.

c.     Who I will be with.

d.    What time I will return.

2.)  If I am going to be late, or change locations. I will call home first.

3.)   If I am scheduled to be home and have to leave before my parents are home, I will leave a note as to my whereabouts and the time I will return.

4.)   We will keep a family calendar and we will schedule all upcoming events on it.

5.)   I will eat dinner at home _______ days a week.

6.)   I will be home after school by _______________.

B.   If I am irresponsible in any of these areas:

1.)  I will talk about my behavior with a parent and accept the following consequences.

a.    _______________________________________________________

b.    _______________________________________________________

c.     _______________________________________________________

C.   Drugs, Alcohol and Paraphernalia

1.)  I will not use any mind-altering chemicals (i.e., alcohol or drugs). In the case of prescription drugs, my family will monitor their use.

2.)   I will not get in a car driven by anyone under the influence of any drug or alcohol.

3.)   I will not bring any drugs or paraphernalia into our house or car.

4.)   I will not have people in the house or car that use drugs.

D.  If I am irresponsible in any of these areas:

1.)  I will talk about my behavior with a parent and accept the following consequences.

a.    _______________________________________________________

b.    _______________________________________________________

c.     _______________________________________________________

E.   TIME LIMITS:

1.)  These are the time limits I will set for myself:

a.    I will be in the house at __________ on weekdays, Sundays through Thursdays.

b.    I will be in the house at __________ on weekends, Fridays and Saturdays.

c.     I will be awake and out of bed at __________ on weekdays.

d.    I will be awake and out of bed at __________ on weekends.

e.    I will be in bed at __________ on weeknights.

f.      I will be in bed at __________ on weekend nights.

F.    If I am irresponsible in any of these areas:

1.)  I will talk about my behavior with a parent and accept the following consequences.

a.    _______________________________________________________

b.    _______________________________________________________

c.     _______________________________________________________

2.)  If I am responsible and follow these time limits faithfully for _____ weeks and _____ weekends, I may earn one (1) extra half hour of time added to either curfew or wake-up on the weekend.

G.  JOBS:

Family members have responsibilities (jobs) at home. I accept the following responsibilities as my own and I understand that there will be times when I will have additional jobs at home.

1.)  _______________________________  _____Daily  _____Weekly  _____As needed.

2.)   _______________________________  _____Daily  _____Weekly  _____As needed.

3.)   _______________________________  _____Daily  _____Weekly  _____As needed.

4.)   _______________________________  _____Daily  _____Weekly  _____As needed.

5.)   _______________________________  _____Daily  _____Weekly  _____As needed.

6.)   _______________________________  _____Daily  _____Weekly  _____As needed.

H.  If I am irresponsible in any of these areas:

1.)  I will talk about my behavior with a parent and accept the following consequences.

a.    _______________________________________________________

b.     _______________________________________________________

c.    _______________________________________________________

I.     DRIVING:

Driving a motor vehicle is a privilege for all persons no matter their age, not an individual right.

1.)  I accept responsibility to maintain the vehicle I drive in a safe and lawful manner.

2.)  I accept the following financial obligations (i.e., gas, oil, insurance, registration, maintenance, payments, etc.):

a.    _______________________________________________________

b.    _______________________________________________________

c.    _______________________________________________________

3.)  I will not be ticketed for any moving violation.

4.)  I will not have more than __________ (____) people in the car at any time.

5.)  I will not allow anyone else to ride in the car that abuses or violates my rule in which I may suffer / accept consequences.

6.)  I accept full responsibility for the actions of any person who I allow to ride in the vehicle.

J.    If I am responsible in any of these areas:

1.)  I will talk about my behavior with a parent and accept the following consequences.

a.    _______________________________________________________

b.    _______________________________________________________

c.    _______________________________________________________

K.  TELEPHONE:

1.)  I will limit my telephone calls to _____ minutes so that others may use the telephone and calls may come into the house. The costs for any of my long distance calls are my responsibility.

2.)  If I misuse the telephone I will accept the following consequences:

a.    _______________________________________________________

b.    _______________________________________________________

c.    _______________________________________________________

3.)  If I am having trouble meeting my expectations, I will ask for help from these people:

a.    _______________________________________________________

b.    _______________________________________________________

c.    _______________________________________________________

L.   NEGATIVE PEERS:

1.)  The following persons are among those that I will not call or spend time with because their lifestyle has a negative influence on me:

a.    _______________________________________________________

b.    _______________________________________________________

c.    _______________________________________________________

d.    _______________________________________________________

e.    _______________________________________________________

f.     _______________________________________________________

2.)  If any of these persons call me or come to see me, I will:

a.    _______________________________________________________

b.    _______________________________________________________

3.)  These are persons who support me and can help me to become the person I want to be. I understand that this list will get longer or change as I become more involved in positive interactions.

a.    _________________________________________ Telephone: ______________

b.    _________________________________________ Telephone: ______________

c.    _________________________________________ Telephone: ______________

d.    _________________________________________ Telephone: ______________

e.    _________________________________________ Telephone: ______________

f.     _________________________________________ Telephone: ______________

4.)  These are negative places and events that I will not attend:

a.    _______________________________________________________

b.    _______________________________________________________

c.    _______________________________________________________

d.    _______________________________________________________

e.    _______________________________________________________

5.)  If I am irresponsible in any of these areas:

I will talk about my behavior with a parent and I will accept the following consequences:

a.)  _________________________________________________

b.)  _________________________________________________

c.)  _________________________________________________

PARENTS

We are changing our lifestyles as co-dependants for our child’s negative behavior and habits. The following area requires change and support of my family. Circle each number or letter that is part of your agreement.

A.   Drugs, Alcohol and Paraphernalia

1.)  I will not bring any drugs or paraphernalia into our house or car.

2.)  I will not have people in the house or car that use drugs.

3.)  I will not use any mind-altering chemicals (i.e., alcohol or drugs).

4.)  I will talk about my behavior with my family.

5.)  I will tell my family about any irresponsible behavior and accept the following consequences:

a.    ______________________________________________

b.    ______________________________________________

c.    ______________________________________________

              DATE: ____________________

               SIGNED: ______________________________                       ______________________________

                                                 TEEN                                                                PARENTS (S)