Parental Consent Template

TinyGuard Care-Management Platform — Parental Consent

Version: 1.1 · Effective: August 12, 2026 · For facility enrollment use

I, [parent/guardian full legal name], am the parent or legal guardian of [child full legal name], born [date of birth]. I authorize [facility name] to use the TinyGuard care-management platform to:

Maintain my child's enrollment record, health and care information, daily activities, attendance, and incident reports.
Communicate with me about my child's care (daily reports, pickup notifications, photos, incident notifications) through the family portal, email, and (optionally) SMS.
Display authorized camera feeds of common areas to me through the family portal, where the facility has enabled parent camera access.
Process payment for my child's tuition or care fees, if I have set up payment through TinyGuard.

I understand that:

My child's information is stored by TinyGuard LLC (Tigard, OR) on my facility's behalf under a Data Processing Agreement between the facility and TinyGuard.
If the facility has enabled AI-assisted care features, still images captured from camera video may be sent to a third-party AI service provider (see TinyGuard's Privacy Policy, Section 5, for current provider(s)) to generate care-related suggestions for staff review — for example, possible falls, injuries, or other safety concerns. These images are used only for this purpose, are not used to train the AI provider's models, and are not viewed by TinyGuard personnel as part of this process.
TinyGuard's Privacy Policy describes how my child's information is collected, used, and protected.
I may request access to, correction of, or deletion of my child's information through the facility or through TinyGuard's privacy team at privacy@tinyguard.co.
I may revoke this consent at any time by notifying the facility.

⛔ No biometrics — by contractual covenant

This consent does not authorize collection of any biometric data (facial geometry, voice prints, fingerprints, iris scans, or similar identifiers). TinyGuard does not offer biometric features at all — this is a hard contractual covenant in TinyGuard's Master Service Agreement §3, reaffirmed per state. See the No-Biometrics Covenant for the full architectural commitment. If TinyGuard ever offered such a feature in the future, the facility would need to obtain my fresh, separate written consent before enrolling my child.

Child information

Child's full legal name

Date of birth

Parent / guardian information

Parent / guardian full legal name

Mailing address

Phone

Facility information

Facility name

Enrollment date

Signature

By signing below, I confirm that I have read this consent in full, that I am the parent or legal guardian of the child named above, and that I authorize the uses described.

Signature of parent / guardian

Date

Printed name

Parent Legal guardian Other authorized adult:

Witnessed by (facility representative)

Facility staff signature

Printed name and title

The facility keeps the executed consent forms; TinyGuard does not centrally store the signed copies. On request, TinyGuard can surface the existence of consent for any specific child whose data is in our system. Questions: privacy@tinyguard.co.