InteractiveTheatre.org Parent/Guardian Permission Form

The minor in your care has submitted a survey that contains NO PERSONAL INFORMATION (and, if s/he snuck it in, I will delete it promptly). The survey is about their activity in educationally-based interactive theatre, and may be used as part of a manual on creating and maintaining interactive theatre groups.

I'm only just beginning the research for this project, and may want to contact people involved at a later date. Because this involved a minor under your care, I would like your permission, in case I wish to contact him/her. Please fill out the following information so I can properly verify that I have permission.

Name:

Minor's name:

Relationship to minor:

Program minor is involved in:

Best method to contact minor:

Phone:

Email:

Thanks for your cooperation - it's greatly appreciated!