Family Media Contract

Television

I agree to only watch shows with a specific rating or lower.
I agree to respect my parents’ decisions about what programs I can watch.
I agree to limit my television viewing to _____ hours per day.

Telephone

I agree to hang up or hand the telephone to an adult, if I am upset with a phone conversation.
I agree not to give out any personal information over the phone.
I agree not to tell anyone on the phone if I am home alone.

Internet

I agree not to give out personal information online.
I agree to limit my online time to _____ hours per day.
I agree to allow my parents to view my social networking profile(s).
I agree to talk to my parents if I feel uncomfortable about something that occurs online.
I agree not to meet an online friend in person.
I agree not to download or install anything without my parents’ permission.
I agree not to open emails from someone that I do not know.
I agree not to purchase anything online without my parents’ permission.

____________________________________________________ Child’s Signature	________________ Date

____________________________________________________ Child’s Signature	________________ Date

____________________________________________________ Parent’s Signature	________________ Date

____________________________________________________ Parent’s Signature	________________ Date