Skip survey header

NYSWYSA Member Survey

Consent Form

This survey should take 3-10 minutes to complete. Your answers to this survey are anonymous and we will not collect your email or other personal information. At the conclusion of the survey you will be provided a link to a new form where you can enter your name and contact info to qualify for the drawing giving away more than 40 prizes including 11-inch iPad Pros, Gaming Headsets, and Nike Bags!
1. Are you... *This question is required.
ELECTRONIC CONSENT (ADULT)
You are invited to participate in a web-based online survey for US Youth Soccer. This information is being compiled by Truclusion, an independent consulting firm. This survey should take approximately 5-10 minutes to complete.
PARTICIPATION: Your participation in this survey is voluntary. You may refuse to take part in this survey or exit the survey at any time without penalty.
BENEFITS: You will receive no direct benefits from participating in this research study. However, your responses may help us learn more about the experiences of soccer players, coaches, volunteers, and staff.
RISKS: The possible risks or discomforts of the study are minimal. You may feel a little uncomfortable/embarrassed/sad/tired when answering some of the survey questions.
CONFIDENTIALITY: Your survey answers will be sent to achumen.com, where they will be stored in a password protected electronic format. This survey does not collect identifying information such as your name, email address. Therefore, your responses will remain anonymous. No one will be able to identify you or your answers, and no one will know whether or not you participated in the study.
CONTACT: If you have questions at any time about the procedures, you may contact our Research Director, Dr. Tiffany M. Quash, via email at tmquash@truclusion.com. 
CONFIRMATION: Please select your choice below. You may print a copy of this consent form for your records. If you feel you have not been treated according to the descriptions in this form, or that your rights as a participant in research have not been honored during the course of this survey, or you have any questions, concerns, or complaints that you wish to address to someone other than the investigator, you may contact Truclusion via email at info@truclusion.com. Clicking on the “Agree” button indicates that
  • You have read the above information
  • You voluntarily agree to participate
  • You are 18 years of age or older
*This question is required.
ELECTRONIC ASSENT (This section must be completed by parent/guardian)
Do you give permission for your child/dependent to participate in the US Youth Soccer online survey? If you agree­­ for your child/dependent to be in this study, we will ask them to complete the questions to the best of their understanding. They will be asked questions in this survey, and to answer each question, they will follow the directions within the survey. This survey should take approximately 3-4 minutes to complete.
BENEFITS: A benefit is something good that happens. Being in this study will help assess and positively impact the culture of United States Youth Soccer’s players, parents/guardians, coaches, and referees.
RISKS: The possible risks or discomforts of the study are minimal. Your child/dependent may feel a little uncomfortable/embarrassed/sad/tired when answering some of the survey questions. They may choose to skip or answer "I prefer not to answer" for these questions. Breach of confidentiality (data being seen by someone who shouldn’t have access to it) is mitigated by (1) data collected is anonymous, (2) we are not collecting personal identifying information such as your name, email address, and (3) we will store all electronic data on a password-protected, encrypted computer. Online data being hacked or intercepted is a risk everyone experiences any time they provide information online. We are using a secure system to collect this data, but we cannot completely eliminate this risk. Personal data collected will be stored securely and will be retained for at most 2 years after last contact.
USE: When we are finished with this study, we will write a report about what we learned. This report will not have your name or your child/dependent's name in it, or that you were in the study.
CONTACT: If you have questions at any time about the procedures, you may contact our Research Director, Dr. Tiffany M. Quash, via email at tmquash@truclusion.com. 
CONFIRMATION: If you have had all your questions answered and give permission for your child/dependent to participate in this study, select Agree below. Remember, your child/dependent’s participation is completely voluntary, and you are free to remove them from the survey at any time. *This question is required.
Please confirm you are a human.
0%