NOTICE TO PARENTS OF MEMBERS SURVEY AT CLUB:
MARCH 5-23, 2018
Our Club is taking part in an annual Survey that will be used to track the wellbeing of members in Boys & Girls Clubs nationally. Our Club is one of a group of Clubs across the country participating in this survey that asks how members feel about the activities and time they spend at the Club, education plans, and involvement in community service and work.
Additionally, the survey asks about the attitudes and health behaviors of Club members, including questions about nutrition and physical activity. Teen members aged 13 and older are asked additional questions around alcohol, tobacco and other drug use, fighting, arrests, and whether teens are sexually active.
Members will be asked to fill out one survey in the spring of 2018 during regular Club hours. The survey takes 30 - 45 minutes to complete, and will be administered online. The only potential risk is that some teen members might find certain questions to be sensitive. The survey has been designed to protect your child’s privacy. Members will not put their names on the survey, and no member will ever be mentioned by name in a report of the results. All information from the survey is being used to assess the wellbeing of Boys & Girls Clubs members and will be kept completely confidential. Only the Boys & Girls Clubs of America national organization that is conducting the survey will have access to the data. Others will see only reports of the information combined for groups of youth in the study or all youth at a Club. No reports will be shared that show your child’s answers on the survey.
Your child will get no benefit right away from taking part in the survey. The results of this survey will help your child and other members of Boys & Girls Clubs in the future by assisting all national Boys & Girls Clubs to develop programming that best meets members’ needs. We would like all members at our Club to take part in the survey, but the survey is voluntary. No action will be taken against the Club, you, or your child if he/she does not take part. Additionally, survey participants can skip any questions they do not wish to answer and may stop participating in the survey at any point without penalty. If you would like to see the survey, a copy is available at the Club. You may review the survey at the Club during regular Club hours between 11:00 a.m. and 6:00 p.m.
Please return this form only if you do NOT want your child to take part in the survey. If you do not want your child to participate check the box above, fill in the above information, sign this form, and return it to the Club by March 2, 2018. If you do not return this form by March 2, 2018, BGCSLC assumes that you have granted permission for your child to participate.
If you have any questions about the survey, please call Rick Scott or Amanda Webb at (479) 675-2764. You can also contact firstname.lastname@example.org. For questions or concerns about your child’s rights as a research participant, contact the Abt Associates Institutional Review Board at 877-250-6835. Thank you!