Beaufort Jasper EOC Head Start

Corporal Punishment

Child's Last Name:*

Child's Middle Name:

Child's First Name:*

Parent's Last Name:*

Parent's Middle Name:

Parent's First Name:*

Date of Birth:*

School Year:*

What program option are you registering for?*

Center:*

The following things listed below are prohibited as disciplinary measures:

• Corporal punishment.
• Any strategy that hurts, shames, or belittles a child.
• Any strategy that threatens, intimidates, or forces a child.
• The use of food as a reward or punishment and denial of basic needs.
• The use or withholding of physical activity as a punishment.
• Isolation and physical force (hitting and/or spanking).

Positive discipline such as redirection and methods involving conflict resolution are the only forms of discipline that will be used.

Conduct of preschool children which disrupts normal classroom activities on a frequent or extended basis may be indicative of physical or emotional problems, which the Head Start program must take steps to address.

I have read the corporal punishment policy stated above. I understand the policy and will adhere to it.

I confirm that I have read and understand this form. *

By checking this option, I choose to manually sign this form.

By checking this option, I prefer to have the system electronically sign this form for me.

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Parent Signature

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