Science Fair Permission Form

 

Student Name_____________________________________________________

 

Science Teacher___________________________________________________

 

Adult Sponsor/Parent Name__________________________________________

 

Title of Project_____________________________________________________

 

Brief Description of Project:

 

______________________________________________(continue on back if needed)

 

Projects involving the following substances or devices are considered hazardous and students must be properly supervised by an adult.  Please check any that apply:

 

        Hazarous, toxic, flammable chemicals                                   Firearms

 

        Equipment-welders, lasers, high voltage                             Radiation

 

        Radioactive Substances

 

The following projects require SRC/IRB approval before experimentation begins.  Forms will be provided by request.  Failure to fill out correct forms before experimentation will result in disqualification of the project.  Please check any that apply:

 

        Human Subjects                                                Potentially Hazardous Biological Agents

 

        Non-Human Vertebrate Animals                   Human or Animal Tissue

 

I understand the risks associated with this project and give my student permission to proceed:

 

 

__________________________________________     ________________________

parent or guardian signature                                                           date