# Permission Form Template — Kids Co-Design Session

For the host org to adapt (their letterhead, their required wording). Two parts: participation and photo/artifact use. We photograph the builds and the boards, not primarily the kids; any photo that includes a child is used only with that child's parent's sign-off, and only for the design write-up.

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## Part A — Participation

Dear Parent/Guardian,

[Host org] is hosting a design workshop for kids on [date], [time]–[time], at [location]. Kids will work in small groups with adults to design a health activity center for kids: what it should have, how it should feel, what would make them want to show up. They'll build a large model from cardboard and craft supplies, explain their ideas, and their work becomes part of a real design document.

This is a design workshop, not a class. There is no physical activity beyond normal indoor movement (sitting on the floor, building, walking around the model). Snacks and water will be provided; please list any allergies below.

My child, ______________________________ (name), has my permission to take part in the design workshop on [date].

Allergies or dietary needs: ____________________________________________

Parent/guardian name: ______________________________  Signature: ______________________________  Date: ________

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## Part B — Photos and ideas

I understand the workshop produces photos of the model, the idea boards, and sticky notes, plus a written summary of the kids' ideas. These may be shared with the host organization, our design partners, and (for selected photos and ideas) in public materials about the project.

Check one:

[ ] I give permission for photos that may include my child, and for their ideas and words to be shared as described.
[ ] I give permission for their ideas and words to be shared, but NOT for photos that include my child.
[ ] I do not give permission for my child's ideas, words, or photos to be shared. They may still take part; their contribution stays in the room.

Parent/guardian name: ______________________________  Signature: ______________________________  Date: ________

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## Notes for the host
- Collect Part A for every child before the session. No form, no participation, no exceptions.
- Part B is a choice, not a requirement. Kids with "no sharing" forms take part fully; their names just don't appear in the write-up.
- Bring one blank copy of both parts to the session in case a parent shows up without one (they can sign at drop-off).
- Keep the originals. The write-up quotes only what Part B allows.