Student and Teacher Feelings about Drills in Schools Study ------ Parental Opt Out Form
Your child's school is taking part in a research study regarding emergency drills in schools. Teachers and students are required to participate in several drills each school year. We would like to find out more about your child's feelings about tornado, fire, and active shooter drills. The study is being conducted by Dr. Cheryl Lero Jonson at Xavier University and Dr. Melissa M. Moon at Northern Kentucky University. Superintendent Alvin Garrison has approved this survey. The survey will take your child approximately 15 minutes to complete.

During the week of October 14th, we are inviting all students in grades 4th-12th grades to take part in the survey. However, the survey is voluntary. Doing this paper and pencil survey (for 4th and 5th graders) or Google Forms survey (6th-12th grade) will cause little or no risk to your child. The only potential risk is that some students might find certain questions to be sensitive. If your child is not comfortable answering a question, he or she may skip it. No action will be taken against the school, you, or your child, if your child does not take part. In addition, students may stop participating in the survey at any point without penalty. If you or your child do not want to participate, an alternative activity will be provided. Although your child may not benefit immediately from taking part in the survey, the information obtained could be helpful when training and implementing drills.

This survey has been designed to protect your child’s privacy. The information that your child gives in the study will be handled confidentially. Also, no school or student will ever be mentioned by name in a report of the results. Any and all identifying materials or data collected to the study, will be maintained on secure, encrypted (via SSL), and password protected websites/databases. Only the two researchers will have the password and be given access.

The Northern Kentucky Institutional Review Board has approved the survey. If you have any questions about the survey please contact the principal researchers Dr. Cheryl Lero Jonson, Xavier University, jonsonc@xavier.edu/ 513-745-1069 or Dr. Melissa M. Moon, Northern Kentucky University, moonm@nku.edu/ 859-572-6979. If you have any questions about your child’s rights as a participant in this survey, you may contact the Chair of NKU’s IRB, Andrea Lambert South, Ph.D., at 859-572-6615 or irbchair@nku.edu.

You do not need to return this form if you would like for your child to participate.

If you do NOT want your child to take part in the survey, 1) check the box below, 2) write your child's name, grade, school, teacher, and school email address, 3) indicate your relationship to the child, 4) date, and 5) submit the form below no later than Thursday, October 10.

You must complete a separate form for each child you wish to opt-out.
If you do NOT want your child to participate in this research study, please check the box below. (NOTE: You must fill out a separate form for each child you wish to opt out.)
Child's Name:
Your answer
Grade:
Your answer
Child's School:
Your answer
Child's Teacher:
Your answer
Child's School Email Address:
Your answer
Your Name:
Your answer
Your Relation to Child:
Your answer
Date:10/
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