School-based Study Parental Consent Form

Study Information

Study Title Principal Investigator/Researcher Description of Study

Participant Information

Student Name Class/Grade

Parent/Guardian Information

Parent/Guardian Name Phone Number Email Address

Consent

I have read and understood the details of the study. I voluntarily give permission for my child to participate in the above-named study. I understand that participation is voluntary and my child may withdraw at any time without penalty.

Parent/Guardian Signature Date