This agreement is made on: _________________ (date)
Between the members of the _________________ family
Daily screen time limits (not including homework):
| Day | School Days | Weekends/Holidays |
|---|---|---|
| Maximum Time | ______ hours | ______ hours |
| Earliest Start | _______ AM/PM | _______ AM/PM |
| Latest End | _______ AM/PM | _______ AM/PM |
Screen-free times:
These areas are device-free:
Where devices charge at night:
When using AI assistants (ChatGPT, Siri, etc.):
AI tools I am allowed to use:
AI tools that need parent permission:
Information I will NEVER share online:
If something online makes me uncomfortable, I will:
Our family code word for "pick me up/I need help" is:
Apps and websites I can use freely:
Apps that need parent approval before downloading:
Apps that are NOT allowed:
If rules are broken:
First time:
Second time:
Repeated breaking of rules:
We agree to review this agreement:
Next review date: _______________________
Child's Signature
Date: _____________
Parent/Guardian Signature
Date: _____________
Additional signatures (if applicable):
_______________________
_______________________