Parent/Guardian Consent Form

PARENT/GUARDIAN CONSENT FORM

Generation Connect (“GC”) brings teen Tech Navigators and Seasoned Adults together through technology, intergenerational programs, community service, and workforce development.

GC has received an application from the teen named below. Please complete this form to confirm that you are the teen's parent or legal guardian and authorize their participation.

TEEN INFORMATION

Teen's Name: [Pre-populated by Generation Connect]

Date of Birth: __________________________ Age: __________

PARENT/LEGAL GUARDIAN INFORMATION

Full Name: ____________________________________________________

Relationship to Teen: __________________________________________

Email: _________________________________________________________

Mobile Number: ________________________________________________

PARTICIPATION CONSENT

I confirm that I am the parent or legal guardian of the teen identified above and authorize my teen to participate in Generation Connect.

Depending on their participation, my teen may take part in:

• Tech Navigator orientation, training, and certification;
• virtual or hybrid intergenerational programs with Seasoned Adults;
• technology and digital-literacy activities;
• leadership and workforce-development training;
• community-service or paid workforce opportunities;
• surveys, assessments, and program evaluations; and
• one-to-one GC Tech Support after completing applicable training and certification.

I understand that interaction with adult participants is an intended part of GC's intergenerational program. GC uses safety measures that may include adult Community Safety Screening, trained staff or facilitators, participant conduct requirements, controlled platform access, and session recording.

I understand that my teen is expected to follow GC's safety, privacy, confidentiality, and professional-conduct requirements and to report inappropriate or concerning interactions to GC staff.

GC TECH SUPPORT & RECORDING

If my teen becomes eligible to provide GC Tech Support, I authorize their participation in one-to-one virtual technology-support sessions with Seasoned Adults.

I understand that all GC Tech Support sessions are recorded for safety, accountability, quality assurance, training, and incident or dispute review. I consent to my teen being recorded during these sessions.

GC may also record portions of group program sessions. Participants will be notified when recording occurs, and teens who do not wish to appear may turn off their camera and refrain from participating in the recorded portion.

I understand that Tech Navigators may not request, retain, or use another participant's passwords, PINs, Social Security number, banking or payment credentials, authentication codes, or similar sensitive information. They may not conduct financial transactions or access financial accounts on another participant's behalf.

PRIVACY, COMMUNICATIONS & PROGRAM SAFETY

I authorize GC to collect and use information reasonably necessary to administer my teen's application, training, certification, participation, service or work hours, assignments, and related program activities.

GC's collection, use, protection, and retention of personal information are described in the Generation Connect Privacy Policy, available on the GC website. GC does not sell personal information or distribute it to third parties for their own marketing purposes. GC may share information only as reasonably necessary to operate and support its programs, comply with legal obligations, protect participant safety, or work with trusted service providers that assist GC under appropriate confidentiality and security requirements.

I authorize GC to communicate with me and my teen about their participation, including programs, training, schedules, assignments, certification, account administration, and safety matters. Providing a mobile number does not by itself provide consent for optional SMS/text messages; SMS consent is handled separately when required.

I understand that my teen must protect information learned through GC and may not independently record, screenshot, publish, or improperly share another participant's private information.

My teen may not use a relationship established through GC to independently solicit or provide paid technology services to a GC participant outside the GC platform unless authorized by Generation Connect.

GC may restrict or end participation when safety, conduct, eligibility, certification, or program requirements are not followed.

OPTIONAL MEDIA & PROMOTIONAL CONSENT

This section is optional. Your choice will not affect your teen's ability to participate in Generation Connect.

Please select one:

☐ YES, I GIVE PERMISSION for Generation Connect to use my teen's name, image, voice, likeness, statements, photographs, video, or program participation in GC communications and promotional materials, including its website, social media, newsletters, presentations, program or impact reports, grant/funder materials, community outreach, press materials, advertisements, and promotional videos.

I understand that I and my teen will not receive compensation for these uses unless separately agreed to in writing.

OR

☐ NO, I DO NOT GIVE PERMISSION for Generation Connect to use my teen's identifiable image, voice, likeness, statements, or participation for public marketing or promotional purposes.

This choice does not affect operational recordings of GC Tech Support or notified portions of group sessions described above.

PARENT/GUARDIAN AUTHORIZATION

By signing below, I confirm that I am the parent or legal guardian of the teen identified above; that I have read and understand this form; and that I authorize my teen to participate in Generation Connect as described.

I understand that GC Tech Support sessions are recorded and consent to my teen's participation in those recorded sessions. I also understand that the optional media permission above is separate from my consent for my teen to participate.

Parent/Guardian Name: ___________________________________________

Signature: _____________________________________________________

Date: ______________________

TEEN ACKNOWLEDGMENT

I understand that I am expected to follow Generation Connect's safety, privacy, confidentiality, and professional-conduct requirements and to contact GC staff if I have a concern or need help.

Teen Signature: _________________________________________________

Date: ______________________

Generation Connect, Inc. info@generationconnect.io | 877-839-3360

Policy version 2026-09-07