Parents Promise Pledge Form


A Parents Promise Pledge Form

Parents’ Promise is a pledge by all Clinton parents/guardians to uphold a set of shared principles aimed at keeping our youth safe and healthy. If you would like your family to be part of our Parents’ Promise Directory by agreeing to practice these shared principles fill out the form below.

Signing the Parents’ Promise pledge sends a strong message to Clinton’s young people that we as adults value them by agreeing to:

  1. Actively supervise all gatherings of youth in our homes or on our property, or ask another responsible adult for help to do so,
  2. Prohibit the possession or use of alcohol, tobacco, and other drugs by youth in violation of the law in our homes or on our property,
  3. Set expectations for our children by knowing where they are going, whom they are with, what they will be doing and when they are to return home.
  4. Contact the parents/guardians of our children’s friends to confirm that they too provide a healthy, drug-free environment for youth gatherings.
  5. Discuss the dangers of alcohol and other drugs with our families.

Parent(s)/Guardian(s) Name (Required)

Subject (Parents Promise)

Your Children (Name(s) and grade(s) in 2011-2012 (Required)

Your Phone Number- To be included in our Connected Home Directory. Please indicate if this is a home or cell phone.

Your Email- If you wish to be added to our e-newsletter database.

Your Signature (Electronic signature- please type your name)

*Before signing, please note the following: 1. By signing, you agree to uphold the shared principles mentioned above. You also allow your name and phone number to be added to the Parents' Promise Directory, and for your email address to be used for the e-newsletter database. 2. Your email address will not be shared with other organizations/businesses. 3. The Parents' Promise pledge is an agreement between a network of parents and is not a legally binding contract.

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