Study Participant’s Name:_______________________________________

I understand the nature of this study as described above and also that the parental/guardian consent as granted above does not require my participation in this study.

I (We) consent to this study and allow my (our) child's

participation:

________________________ _________________________

Signature Signature

Parent or Legal Guardian Parent or Legal Guardian

I understand the nature of this study as described above.

I consent to my participation in this study.

_______________________________

Signature

Study participant