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Anti-Bullying Form - Stockbridge Middle School Bands


									                               Stockbridge Middle School Band
                               Anti-Bullying/Hazing Agreement

Students will not threaten, intimidate, harass, make physical contact with or subject
another student to any other form of physical or emotional hurt, including hazing
associated with membership in extracurricular organizations (sports teams, band, etc.).
The director of bands and selected school officials will address even one act of
bullying/hazing if it occurs. Actions that violate this agreement include but are not limited

1.    Verbal assaults such as unwanted teasing or name-calling
2.    Threats, taunts and intimidation through words and/or gestures
3.    Direct physical contact such as hitting or shoving, physical violence and/or attacks
4.    Destruction of school or personal property
5.    Any form of electronic bullying or cyberbullying using school equipment, school networks,
        or e-mail systems, or using personal equipment during school
6.    Theft of money and/or personal possessions for the purpose of bullying, harassing, or
7.    Harassment or intimidation motivated by any actual or perceived characteristic including
        race, color, ethnicity, religion, gender, gender identity, sexual orientation, ancestry, national
        origin, physical attributes, socioeconomic status, physical or mental ability or disability, or
        by any other distinguishing characteristic
8.    Public humiliation or social isolation
9.    Extortion or manipulation, including incitement and/or coercion
10.   Rumors or spreading of falsehoods
11.   Stalking
12.   Cyberstalking or engaging in conduct to communicate, or to cause to be communicated,
        words, images, or language by or through the use of e-mail or electronic communication
        directed at or about a specific person, causing substantial emotional distress to the victim
13.   Cyberbullying or the willful, hostile and repeated harassment and intimidation of a person
        through the use of digital technologies, including, but not limited to, email, blogs, social
        networking websites (e.g., MySpace, Facebook, etc.), chat rooms, texts, and instant
14.   Using cameras or camera phones to take embarrassing photographs of students or school
        employees and distributing them to others or posting them online; Sending abusive or
        threatening text messages or instant messages
15.   Using websites to circulate gossip and rumors to other students

By signing this form, students agree to refrain from engaging in any of these behaviors.
Also, students and parents who witness any of these violations must inform the band
director and/or school administrators immediately. Any student suspected of committing
any of the above actions will be thoroughly investigated. Any student found guilty of any
of these offenses will incur a level 5 consequence in which the student will be referred to
the administrative team for immediate dismissal from the band program.

_______________________________________________________________                _______________________

Student Signature                                                                       Date

_______________________________________________________________                _______________________

Parent/Guardian Signature                                                               Date

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