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Home Rules Contract
This is the form itself. Every family member named below is agreeing to follow the rules and consequences written here.
If you have not decided how to choose your five behaviors or what makes a consequence useful, work through "Home Rules Contract: A Guide for Families" first, then come back and fill this in. Give a blank copy to everyone who will sign, teens included, and fill in the final version together.
This contract is for the ______ family
e.g. Family last name
______________________________________________
The Five Rules
Write the expectation clearly enough that nobody can say they misunderstood it. Then write the consequence for breaking it and the privilege that stays in place while it is kept. Only write consequences you are willing and able to enforce.
Rule 1
e.g. The expectation, stated plainly
______________________________________________
Rule 1 — consequence
e.g. What happens when this rule is broken, and what happens if it is broken again
______________________________________________
______________________________________________
Rule 1 — privilege
e.g. What stays in place while this rule is kept
______________________________________________
______________________________________________
Rule 2
e.g. The expectation, stated plainly
______________________________________________
Rule 2 — consequence
e.g. What happens when this rule is broken, and what happens if it is broken again
______________________________________________
______________________________________________
Rule 2 — privilege
e.g. What stays in place while this rule is kept
______________________________________________
______________________________________________
Rule 3
e.g. The expectation, stated plainly
______________________________________________
Rule 3 — consequence
e.g. What happens when this rule is broken, and what happens if it is broken again
______________________________________________
______________________________________________
Rule 3 — privilege
e.g. What stays in place while this rule is kept
______________________________________________
______________________________________________
Rule 4
e.g. The expectation, stated plainly
______________________________________________
Rule 4 — consequence
e.g. What happens when this rule is broken, and what happens if it is broken again
______________________________________________
______________________________________________
Rule 4 — privilege
e.g. What stays in place while this rule is kept
______________________________________________
______________________________________________
Rule 5
e.g. The expectation, stated plainly
______________________________________________
Rule 5 — consequence
e.g. What happens when this rule is broken, and what happens if it is broken again
______________________________________________
______________________________________________
Rule 5 — privilege
e.g. What stays in place while this rule is kept
______________________________________________
______________________________________________
Family Agreement
Every family member involved in this contract names themselves here and confirms they agree. Read the five rules out loud together before anyone checks a box. Leave blank any rows you do not need.
Parent or caregiver 1 — name
e.g. Full name
______________________________________________
- [ ] Parent or caregiver 1 — I agree to these rules
Parent or caregiver 2 — name
e.g. Full name
______________________________________________
- [ ] Parent or caregiver 2 — I agree to these rules
Other caregiver 1 — name and role
e.g. Full name, and how you are related (step-parent, grandparent, guardian)
______________________________________________
- [ ] Other caregiver 1 — I agree to these rules
Other caregiver 2 — name and role
e.g. Full name, and how you are related (step-parent, grandparent, guardian)
______________________________________________
- [ ] Other caregiver 2 — I agree to these rules
Teen or child 1 — name
e.g. Full name
______________________________________________
- [ ] Teen or child 1 — I agree to these rules
Teen or child 2 — name
e.g. Full name
______________________________________________
- [ ] Teen or child 2 — I agree to these rules
Teen or child 3 — name
e.g. Full name
______________________________________________
- [ ] Teen or child 3 — I agree to these rules
Teen or child 4 — name
e.g. Full name
______________________________________________
- [ ] Teen or child 4 — I agree to these rules
Date we agreed to this contract
e.g. MM/DD/YYYY
______________________________________________
Date we will review and renegotiate it
e.g. MM/DD/YYYY
______________________________________________
Privileges a teen has asked to earn by the review date
e.g. Write down what they want to work toward — it gives the contract somewhere to go
______________________________________________
______________________________________________
______________________________________________
Everyone signs, or it is just a list: A contract one parent enforces and another quietly ignores teaches your teen which adult to ask. What makes this document work is not the rules — it is that every name on it is holding the same line.
Go deeper
Ready for more? These lessons pick up where this worksheet leaves off.
- Parenting, from The Neurodiverse Couples Repair Program. The parenting session for neurodiverse couples: understand your child together, agree on what counts, share the load, and protect the couple.
- Your Family Operating Manual, from Parenting Autism. Pull the whole course into one living family manual, with a fridge-door page and a weekly huddle.
- Your Parenting Style Under Pressure, from Parenting Autism. Why stress pushes good parents into laxness or over-reactivity, the short-fuse neuroscience, the Parenting Scale, and repair after you lose it.
