Intergenerational Program Planning Form

Planning form for events that pair residents with school groups, scouts, or youth volunteers. Captures program goals, participant details, accessibility needs, safety screening, logistics, and post-event reflection.

Program Overview

• Program name
• Requested date
• Requested start time
• Estimated duration (minutes)
• Program type
• Brief program summary
  Describe what participants will do in 2-4 sentences. Avoid collecting unnecessary personal details.

Participants and Partners

• Requester name
• Requester role
• Partner organization name
• Partner group type
• Estimated number of youth participants
• Estimated number of resident participants
• Resident participation level

Learning Objectives and Activity Design

• Learning objectives
• Activity format
• Materials needed
  List only the materials required to run the activity safely and successfully.
• Will food or beverages be served?
• Food allergy and dietary accommodation plan
  Describe how allergen labeling, ingredient review, and dietary restrictions will be handled.

Safety, Accessibility, and Supervision

• Has the partner organization confirmed required background screening or youth supervision checks?
  Confirm any organization-specific screening, chaperone, or supervision requirements before the visit.
• Planned adult-to-youth supervision ratio
• Accessibility needs or reasonable accommodations
• Behavioral or cognitive support needs
  Describe any support needs relevant to resident participation. Do not include unnecessary PII.
• Has the emergency response plan been reviewed with staff and the partner group?
• Supervision notes
  Include staffing assignments, resident escort needs, and any areas requiring restricted access.

Logistics, Consent, and Communication

• Event location
• Is transportation needed for the partner group or residents?
• Transportation details
• PII disclosure acknowledged
  I understand this form collects only the minimum necessary information to plan and approve the program, and that submitted information will be used for scheduling, safety review, and audit trail purposes.
• Photo or video permission required?
• Communication plan
  Describe how residents, staff, and the partner organization will receive updates before and after the event.

Post-Event Reflection

• Was the event completed as planned?
• Attendance summary
  Summarize actual participation, including any significant changes from the original plan.
• Resident feedback
• Partner feedback
• Lessons learned and improvements for next time