2015-16 SAFEHOME PLEDGE

Please take the time to review the pledge with your child. Parents possess the unique power to help their children stay healthy and drug free. Children want, and need, this information from parents. Kids are choosing to experiment with alcohol and drugs because they are readily available, there is little perceived risk and the use is considered socially acceptable. Most teens who choose to say no to alcohol, tobacco or other drugs, credit their parents for their decision.

The SafeHomes community takes a united stand against alcohol and drug abuse by minors. Please help our efforts to safeguard children from the social pressures related to underage use of alcohol and other drugs.

Directions: Please complete one form per family, print and have your child turn in to his/her homeroom teacher. All parents/guardians who sign the pledge card and complete all information legibly will be included in the On-Line SafeHome Directory.

“I PLEDGE TO PROVIDE A SAFEHOME”

For parents of K-5 students:

I will provide adult supervision for all children visiting my home.

I will provide a secure storage place for all forms of alcohol,

firearms and other potentially hazardous items.

I will communicate with other parents.

I will provide a safe, drug-free environment for my child to grow.

For parents of 6-12 students:

I will not allow parties or other gatherings in my home

when I am not there.

I will not serve minors nor will I allow youth under the legal drinking

age (21) to consume alcohol in my home or on my property.

I wish for communication with any parent who observes

my child using alcohol or other drugs.

I will communicate with any SafeHomes parent of a child I personally

observe using alcohol or other drugs.

Ms.

Mr. & Mrs. ______

Mr.please print

Signature ______

Mailing Address ______

Town/Zip______Phone______

(phone numbermust be provided or information will not be included in directory)

*Directory information will be listed by the child’s last name*

Name of school age child(ren) – Please list all school age children in your family and complete only one sheet per family.

1. ______

2. ______

3.______

4.______

5.______