Page 129 - Social Norms Survey

ANNEX 1

CULTURE CHANGE FOR PEACEFUL CO-

EXISTENCE

Parent Release Form

The school your child attends is taking part in a focus group for the Violence Prevention
Alliance (VPA) in partnership with the Citizen Security and Justice Programme (CSJP) of
the Ministry of National Security.

Your child is one of those participating. This focus group is not difficult, and neither are
there any risks that your child would face by participating. It involves having a discussion
with a group of other children from the school. The discussions will be audio-taped.

We need your permission in order to include your child.

Purpose of the Focus Group: The purpose is to hear the opinions and views of children
about violence and crime and to learn the concerns that they have, and their perspec-
tives on how to mitigate violence and abuse in the community. The children will be asked
to express their thoughts and feelings in a group with other children from the school.

Confidentiality: No personal information about your child will be recorded. A coded num-
ber will be used to indicate each participant. Your child’s opinions will be used only for
research. We will respect privacy

Consent: By signing this form, I agree that:
1) The study has been explained to me. All my questions were answered.
2) I understand that no information that would identify me, my child or my family, will
be released or printed without asking me first.

I hereby AGREE to have my child (name) ______________________________________________
participate in the focus group session on (date/time) _________________________________

______________________________________________________________________________________
Name of Parent_______________________________________________________________________
Signature_of Parent___________________________________________________________________

Date ______________________________

Should you have any questions, please contact: __________________________________ at
_________________.

The VPA thanks you for your cooperation.

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