Transcription of Home Rules Contract - TEENS WITH PROBLEMS
1 home Rules Contractfor_____ family (last name of family )All family members , whose signatures are present on this document below, are in agreement with and willfollow the Rules and consequences of this home Rules Contract as listed:1. (list rule) _____Consequence:_____ Privilege:_____2. (list rule) _____ Consequence:_____ Privilege:_____3. (list rule) _____Consequence:_____Privilege:_____4. (list rule) _____Consequence:_____Privilege:_____5. (list rule) _____Consequence:_____Privilege:_____Sig natures of family members ( Contract must be signed by all family members involved in Contract )Caregivers!_____Parent!_____Par ent!_____Step Parent!_____Step ParentOther Caregivers!_____Grandparent #1!_____Grandparent #2!_____Other Caregiver #1!
2 _____Other Caregiver #2 TEENS /Preteens!_____Teen/child #1!_____Teen/child #3!_____Teen/child #5!_____Teen/child #2!_____Teen/child #4!_____Teen/child #6
