THE CATHOLIC UNIVERSITY OF AMERICA
Department of Psychology
Washington, DC 20064

I am the parent/guardian of _______________________________ [student's name] and I understand that my child is currently enrolled in PSY201, General Psychology, and that he/she is expected to learn about research in psychology by participating in a series of empirical studies. Studies typically involve computer tasks, completion of surveys, response to audio or video presentations, completion of standardized tests, etc. They are approved by the University's Institutional Review Board and there will be no disclosure of individual performance. Each of these studies is required to provide my child with a Consent Form prior to their participating. However, since my child is not yet 18, he/she does not have the legal status to consent to participate. I understand that my child may refuse to participate in any study to which s/he has any objection.

I therefore [check one]:

_____ Delegate authority to my child to sign individual Informed Consent forms for empirical studies associated with courses in the Department of Psychology.

_____ Retain authority to sign individual Consent Forms for any study in which my child participates.

_____ Do not want my child to participate in any studies, and therefore would like him/her to be assigned an alternative activity.

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Signature Student Signature

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Printed Name

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Relationship to Student

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Date