VASSAR COLLEGE Department of [Insert name] Parent/Guardian Consent Form

(Form 2: omit this label)

Primary Investigator: [Insert the name of the professor/supervisor]

Student Researcher(s):

Title of Project:

I acknowledge that on _____, I was informed by [Insert the name of the professor or administrator] College of a research project having to do with the following:

In this section, please:

1. overview the nature of the research project;
2. overview the basic procedures/types of questions and the participant's role;
3. explain how confidentiality will be maintained;
4. describe the approximate duration of participation;
5. provide contact information (e.g., e-mail and phone number of the primary investigator) and state that participants may contact the PI with questions or concerns.

Potential Risks:
[describe any potential risks and the level of risk]

Potential Benefits: [describe any potential benefits] I am aware, to the extent specified above, of the nature of my child’s participation in this project and the possible risks involved or arising from it. I understand that I may withdraw my child’s participation in this project at any time without prejudice or penalty of any kind. I hereby agree to allow my child to participate in the project. Date: _______________________ ________________________ (Printed name of Legal Guardian) _________________________________ _________________________________ Home Address (Signature of Parent/Legal Guardian _________________________ (Printed name of Child Participant)