A template that you can use to create a minors consent form for your project. This template provides sample text and can be adapted for use based on the context of your project and participant needs. You may wish to communicate the content verbally or in another form that works best for your participants.
It can be helpful to use a template as a starting point in order to customize your own minors consent form.
Minors Consent Form Template
Use this template as a starting point to create a minors consent form for your project.
[Project Name] Consent Form
Hello, my name is [Researcher’s Name]. I am working on a research project about [primary goal of the project]. The project research team will be visiting [Organization Name] during the year to learn from you and others about how we can make this project better. We call this activity a co-design session because participants help us to come up with design improvements. During our visit, our team may ask you to take part in different activities or try out different apps or other digital designs. We will then ask you to join two or three of your peers to discuss your experience and come up with different ideas to improve the designs. At the end of this activity, you will have a chance to share your ideas with the rest of the participants and hear their feedback as well. During this activity we may take notes. The notes that we collect will be kept safely locked up. We will not tell anyone else your name, and if we write about or present our research we will not use your name or the name of [Organization Name].
We are asking if you agree to participate. We will need your parent or guardian to give permission, too. If you participate in the project, there is no risk to you, and your [grades or relationship with Organization Name] will not be affected. You do not have to participate, but if you do agree to participate you can change your mind at any time by letting your parent, [organization staff], or someone on the research team know that you want to stop participating. If you decide to stop your participation that is OK with us and we won’t ask you any questions about your decision. If you have questions about the co-design session you can ask them at any time before, during or after the session.
☐ I have read the information on this form and understand it. YES, I would like to participate in the co-design session with the permission of my parent/guardian.
☐ I have read the information on this form and understand it. NO, I do not want to participate in the co-design session even with the permission of my parent/guardian.