Behavioral Reflection Form:

What happened?

Is this behavior Safe?

Is this behavior respectful?
Is this behavior honest?
How will you avoid this behavior in the future?

Student Signature:
Coaches Signature:

Behavioral Contract
I _________________________________________ agree to the following terms:
These are my goals:
1. _____________________________________________________________
_____________________________________________________________
2. _____________________________________________________________
_____________________________________________________________
3. _____________________________________________________________
_____________________________________________________________
4. _____________________________________________________________
_____________________________________________________________
These are my rewards/reinforcers if I meet my goals:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
These are my consequences if I do not meet my goals:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

Signatures:

Student Signature:___________________________________ Date:____________

Teacher Signature:___________________________________ Date:___________