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.
Signature Student Signature
Relationship to Student