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Georgetown Early Learning Project
Georgetown University, Department of Psychology, 301J White-Gravenor Building, Washington DC 20057, ph. 202-687-6988
Infant’s Name________________
Informed Consent for the Study of Infant Learning and Memory
1. The Early Learning Project conducts research on the development of memory over the first two years of life.
I confirm that the Staff visitor has described the purpose of the study, the study procedures, and the visitation
pattern for my infant and has answered all questions that I may have had.
2. I understand that records of my infants' participation will be used for research purposes only and will remain confidential.
3. I understand that, by definition, infants constitute a "risk" category and that the University and investigators
provide no compensation for any unforeseeable medical treatments or injuries of any kind that might result.
4. I understand that my (and my infant's) participation in the study is strictly voluntary, and we may withdraw from the study at any time.
5. I understand that my infant may be videotaped for coding purposes and may be viewed by other research staff.
Videotapes will be stored in a locked cabinet.
6. I understand that if I have any questions or problems regarding the study, I can contact Dr. Rachel Barr at 202-687-6988.
If I have any additional questions regarding mine or my infant's rights as research participants I have been advised that I may
contact the Office of the Dean of Research and Graduate Education, 202-687-1506.
7. I confirm that I have received a copy of this form.
Signed______________________
Relation to Infant______________
Date________________________
8. I consent to having demographic and contact information gathered during this study added to the Georgetown Research
Volunteer Program (GRVP) database (grvp.georgetown.edu) . Your information will only be available to other GRVP
researchers at Georgetown University. I understand that saying yes means that I might be contacted at a later date
for a different study myself or other family members and can choose whether or not to participate at that time.
___YES (initials) ____
___NO
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