Consent INFormATION

Consent and Assent Form to Participate in Robotics Research

This section contains the text in the printed CONSENT and ASSENT form provided to parents and students participating in the study. This section is intended to be completed by parents and participants in the study and submitted to the researcher.

*** This section is provided here as a sample. If YOU are participating in the study, please DOWNLOAD the actual consent and assent form here (PDF file). Please have your parents complete the form with their name signature as well. You will also need to complete the assent portion by writing your name and signing the form.***

Research Consent & Authorization Signature Section

• Voluntary Participation - You are not required to participate in this study. In the event you do participate, you may leave this research study at any time. If you leave this research study before it is completed, there will be no penalty to you, and you will not lose any benefits to which you are entitled.
• If you agree to participate in this research study, sign this section. You will be given a signed copy of this form to keep. You do not waive any of your legal rights by signing this form.

SIGN THIS FORM ONLY IF THE STATEMENTS LISTED BELOW ARE TRUE:

• You have read the above information.
• Your questions have been answered to your satisfaction about the research.

Parental/Guardian or Legally Authorized Representative (LAR) Signature Section

• I am voluntarily giving my consent for my child/legal ward to participate in this study because I believe my child/legal ward would want to take part if able to make the decision and I believe it is in my child's/legal ward's best interest.

*Person giving Consent must select whether they are a Parent/Guardian or a LAR.