Find a child (0-12 years of age) and parent(s) who are willing to allow you to perform at least 30-45 minutes of observation.
The University of Texas Permian Basin follows ethical guidelines established by the American Psychological
Association and the Campus Ethical Review Board. This class project has been review by the Campus Ethics
Committee and has been approved for use in the educational purpose of training students to be aware of
developmental processes during the life-span. Students in the class will observe a child for the purposes
The student ________________________________ (insert student’s name), must have your written permission
in order to conduct the observation After reading this informed consent form, if you approve of the process
and student use, please sign and date below. The student will send this consent form to the instructor who
will use it to verify that the student has followed consent guidelines. Your child’s and your information will
remain anonymous and the consent forms will be protected by electronic password that is instructor accessible
only. After the class semester is over, the permission slips will be destroyed.
Each student in the Life-Span class will observe a child between the ages of 0-12. Your cooperation is
appreciated. However, if at any time you wish to withdraw from the process, you may do so and the student
will stop and destroy the information gathered and the permission slip. You may keep a copy of this informed
consent form. The student cannot divulge your/ your child’s identity to other students. The student will
summarize what he or she has learned and how it relates to theories and concepts in the class. The student
will submit the final product to the instructor and to the class. Other students will look at each other’s
submissions and briefly describe how their own observations were similar or different from other students’.
No identities of participants are made available at any time.
I consent for my child to be observed for this class project and agree that my/ my child’s information may be
used as described above.
Signature: ____________________________________________ Date: __________________