Campus Locations: Storrs Campus: 115 N Eagleville Rd Storrs, CT 06269 Waterbury Campus 99 E. Main Street Waterbury, CT 06702 PARENTAL INFORMATION AND SIGN-UP SHEET Are you and your child interested in becoming involved in research? Look no further than the UCONN K.I.D.S. Contact Database! This participant database encompasses several of UConn’s research labs across the Psychology, Linguistics, Speech, Language, and Hearing Sciences, and Human Development and Family Studies Departments that do behavioral research on all kinds of children, from infants to adolescents. Research topics include, but aren’t limited to: Language Development Self-control Early Cognitive Development Language Disorders/Hearing Loss Peer Relations Speech/Language Comprehension Cognitive Skills in Deaf Children Social Information Processing What is the Purpose of UCONN K.I.D.S.? With entry into UCONN K.I.D.S. contact database, parents can be contacted (via email or telephone) about future studies in which their infant/child/adolescent is eligible for. In addition, with database membership parents can express interest for specific research studies listed on the database. How Do I Join? It’s easy and takes only one step! You can choose one of the different ways listed below to join: Provide your information and check the “yes” box on the second sheet below Sign up online, via the database website (www.kids.uconn.edu) Check the “maybe” box on the sheet below and call or email the Child Research Recruitment Coordinator Phone Number: 860-486-3820, Email: kids@uconn.edu) or provide us with contact information today and an ideal time to contact you regarding participation. What Happens After I Join? You may be contacted if your child is eligible for a current study. Participation in the database and any study is completely voluntary. Once you have entered the database, you can be removed from the database at any time by calling or emailing the Child Research Recruitment Coordinator (contact information above). The database will also monitor participant involvement so you are not contacted for an overwhelming amount of studies. Incentive for your child’s participation (such as small gifts) varies by study. Your Information is Secure: The web server and UCONN K.I.D.S. Contact Database application runs on a secure, password protected system through the University of Connecticut. o This database application is locked down to any access except from our applications server and meets all security requirements of the University of Connecticut. o Only Principal Study Investigators from each lab, the Child Research Recruitment Coordinator, and designated graduate students working on research for each lab have access to the database and participant information. The information provided for the contact database is completely confidential. o Children’s full names and other identifying information will not be made public. o All records associated with the UCONN K.I.D.S. Contact Database will be kept in a locked room with locked cabinets and/or password protected computers with password protected files. Participant Sign-Up Information and UCONN K.I.D.S. Agreement Please complete the information below for entrance into the UCONN K.I.D.S contact database. This sheet is also at www.kids.uconn.edu if you wish to sign-up online. You do not have to provide any information that you do not feel comfortable with. If you choose to not provide certain information, you are still allowed entry into the database, though this information is used to help determine your child’s eligibility of particular studies. In the final row, please check one of the four options in response to the UCONN K.I.D.S. Contact Database Agreement Statement. Parent(s) Name(s) Child or Children’s Name(s) Child or Children’s Sex(es) (M/F) Child or Children’s Birth Date(s) Any Special Information Phone Number(s) Email Address(es) Mailing Address Preferred Contact/Method/Time(s)/Day(s) Ethnicity (optional) I agree to have my child’s information in the UCONN K.I.D.S. Contact Database Caucasian/White African American/Black Hispanic/Latino Asian American Indian/Alaskan Native Native Hawaiian/Pacific Islander Yes, I agree. No, I do not agree. Maybe. Can you contact me later? Maybe. Can I contact you later?