Actual Consent Form used here:

Consent Form (Minor)

I agree to allow my child to participate in the usability study conducted by [Agency/Organization].

I understand that participation in this usability study is voluntary and I agree to immediately raise any concerns or areas of discomfort my child or I might have with the study administrator.

Please sign below to indicate that you have read and you understand the information on this form and that any questions you might have about the session have been answered.

Date:_________

Child’s name: ________________________________________________

Please print your name: ____________________________________________________

Please sign your name: ____________________________________________________

Thank you!

We appreciate your participation.

Source: Usability.gov