Skip survey header
English

Elevate Youth California-Youth Development Survey Parent/Guardian Consent Form

Information

Dear Parent or Caregiver:

Hello! Your child is eligible to participate in a study on youth development programs in California. The goal of the study is to understand if and how youth programs support young people. The study is being led by Education Northwest on behalf of the statewide Elevate Youth California initiative. 

We are asking for your permission for your child to participate in a survey. The online survey will ask your child questions about supports they have in their life, including within youth programs. The survey is accessed online and takes less than 30 minutes to complete. There are no anticipated personal benefits, but the information your child shares in the survey will help improve youth program services across the state of California.

The survey questions will ask about your child’s …  
  • Access to mentors and mentorship quality
  • Quality of program experiences and impact of being involved in youth programming
  • Participation in civic engagement/political or social justice activities and leadership opportunities
  • Perspectives on the impact of substance use and strategies to prevent substance use

Only youth who have consent from a parent or guardian will be invited to complete the survey. Once invited, youth are free to choose to participate in the survey. This means that your child can still choose not to participate in the survey if you give consent.
There is some element of risk in your child's participation: 

Possible risk: Some youth may feel uncomfortable answering the survey questions or may not fully understand the questions.
What we will do to reduce the risk: If your child begins the survey, they may stop at any time with no negative consequences and skip any questions. Your child’s level of participation will not affect their enrollment in their school or youth development program. 

Possible risk: Someone might be able to identify your child’s responses. 
What we will do to reduce the risk: Not share identifiable individual responses with anyone; Combine your child’s response with all other survey response for a summary report.

Possible risk: A breach of data may occur, exposing your child’s survey responses. 
What we will do to reduce the risk: Keep all individual responses secured electronically in Education Northwest systems; Remove anything which could identify your child from our records; Parents/guardians will be informed if a data breach occurs on Education Northwest systems.
The summary report will be shared with Elevate Youth California (EYC), however, individually identifiable information will never be shared with EYC or anyone else. All information collected from the youth survey will be used for this study only. 

If you have any questions about this survey or study, please contact Marbella Uriostegui at marbella.uriostegui@ednw.org or 503.275.9496 Ext. 496. 
2. To give your child permission to take the Youth Survey, please complete the information below.