Acknowledgement Form for Minor Participants
Please read the statements below and indicate your agreement to those statements by signing and dating the
form at the bottom of the page.

I acknowledge that I am under the age of 18 and am considered a minor for the purposes of
psychological research.

I have been given the opportunity to read the consent form for this study and to ask questions about the
study as necessary.

I understand that I am participating in the research process for educational purposes only, and that any
data collected from me during this process will be omitted from the final results and will not be used for
research purposes.
Minor Participant Statement and Signature: I understand and agree to the above statements.
__________________________________
Signature of minor
________________
Date
___________________________________
Printed name of minor
Acknowledgement Form for Minor Participants
Please read the statements below and indicate your agreement by signing and dating the form at the bottom of
the page.

I acknowledge that I am under the age of 18 and am considered a minor for the purposes of
psychological research.

I have been given the opportunity to read the consent form for this study and to ask questions about the
study as necessary.

I understand that I am participating in the research process for educational purposes only, and that any
data collected from me during this process will be omitted from the final results and will not be used for
research purposes.
Minor Participant Statement and Signature: I understand and agree to the above statements.
__________________________________
Signature of minor
___________________________________
Printed name of minor
________________
Date