Sample Assent Form for Minors



Sample Assent Form for Minors

My name is {identify yourself to the child by name}. I am a student researcher from Florida State University. I am asking if you would like to take part in a research study called “Math Skills in Youth”, which is about adding and subtracting numbers.

If you agree to be in this study, you will take home a four (4) page booklet with math problems and instructions. The math problems will involve adding and subtracting numbers, and you will also look at pictures of things in nature to count. It may take you about 45 minutes to work on the booklet.

Working with the booklet may make you feel a little frustrated. This study may help teachers learn better ways to help students with their math skills.

Please talk this over with your parents before you decide whether or not to participate. We have asked your parents to give their permission for you to take part in this study. But even if you parents said “yes” to this study, you can still decide to not take part in the study, and that will be fine.

If you do not want to be in this study, then you do not have to participate. This study is voluntary, which means that you decide whether or not to take part in the study. Being in this study is up to you, and no one will be upset in any way if you do not want to participate or even if you change your mind later and want to stop.

You can ask any questions that you have about this study. If you have a question later that you did not think of now, you can call me at 850-555-1234, or ask me next time.

Signing your name at the bottom means that you agree to be in this study. You and your parents will be given a copy of this form after you have signed it.

Name of child (please print)

Signature of Child Date

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download