PARENT PERMISSION FORM
So your child is interested in joining MOOSE crossing? Terrific!
MOOSE Crossing is a research project of Amy Bruckman and the Georgia
Institute of Technology. The goal of MOOSE Crossing is to give kids a
meaningful context to learn reading, writing, and computer
programming. Access is free, and is open to kids 13 and under.
Adults 18 and over must apply to be mentors or "Rangers." Teenagers
14-17 must apply to be Junior Rangers. If you have any questions
about registration, see: http://www.cc.gatech.edu/~asb/moose-crossing/
For your child to participate, you must complete both the parent and
child application forms, and the parent questionnaire, and connect to
the MOOSE Crossing login screen to request a character (if you have
not already done so). This parental permission form has two parts: an
informed consent form, and a code of conduct.
We believe (but can not guarantee) that your child will learn from
his/her participation in this project. This project involves use of
the Internet, and all Internet usage for children involves possible
risks. While we try to provide a safe environment, we can not
guarantee that some third party will not use the system to make
inappropriate materials available to children, or that dangerous
persons will not gain access to the system. To help educate your
child about safe Internet use, a code of net safety is provided.
Reports of injury or reaction should be made to Amy Bruckman at
404-894-9222. Neither the Georgia Institute of Technology nor the
principal investigator has made provision for payment of costs
associated with any injury resulting from participation in this study.
For research purposes, almost everything that is typed on MOOSE
Crossing is recorded. Participants are also occasionally asked to
answer interview questions by phone, email, or in person. This data
will be kept confidential, and will be used only for research
purposes. Descriptions of your child and records of his or her
experiences may appear in written and oral presentations of the
results of this research, with his or her name changed to ensure
confidentiality.
Your child has rights as a research volunteer. Taking part in this
study is completely voluntary. If your child does not take part, there
will be no penalty. Either you or your child may discontinue your
child's participation at any time with no penalty. If you have any
questions about your rights as a research volunteer, call or write:
Barbara S. Henry, Manager, Contracting Support Division
Office of Contract Administration
Georgia Institute of Technology
Atlanta, Georgia 30332-0420
404-894-6944
Your signature below indicates that the researchers have answered all
of your questions to your satisfaction and that you consent to your
child's participation in this study.
_____________________________________________
Parent or Legal Guardian--Print Your Name Here
_____________________________________________ ____________________
Parent or Legal Guardian--Sign Your Name Here Date
CODE OF CONDUCT
A code of conduct is included on the child application form. This
includes guidelines for behavior expected of participants. If your
child breaks the rules, his/her account may be either temporarily or
permanently discontinued. Membership in MOOSE Crossing is a
privilege, not a right.
The code of conduct also includes guidelines for your child's safety.
One authority on the subject of child safety online writes: "Most
people who use online services have mainly positive experiences. But,
like any endeavor--traveling, cooking, or attending school--there are
some risks. The online world, like the rest of society, is made up of
a wide array of people. Most are decent and respectful, but some may
be rude, obnoxious, insulting, or even mean and exploitative."
We recommend that you ask your child:
* Not to give out your home address or phone number to anyone he/she meets
online, and
* Not to agree to meet anyone face to face.
If your child wants to meet another child face to face, we recommend that you
set up a meeting in a public place, and make sure each child is accompanied by
a parent.
CODE OF CONDUCT--PARENTAL AGREEMENT
I have spoken with my child about the code of conduct, and he/she understands
it and has promised to abide by it.
I have spoken with my child about the importance of not giving out our home
address or phone number, or meeting with people face to face. My child
understands why this is important and will abide by it.
_____________________________________________
Parent or Legal Guardian--Print Your Name Here
_____________________________________________ ____________________
Parent or Legal Guardian--Sign Your Name Here Date
_____________________________________________ _________________
Witness--Sign Your Name Here Date
To activate your child's account, we need to make sure we can match up parent
forms, child forms, and online applications. Has your child already requested
a MOOSE Crossing character online? If so, what character name did he/she
request?
_____________________________________________
Print Character Name Requested
_____________________________________________
Email Address (parent's, child's, or both)
_____________________________________________
Print CHILD's name here
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Please print out this form, the kid form, and the parent questionnaire.
Complete them, sign them, and return them via surface mail to:
MOOSE Crossing Applications
c/o Amy Bruckman
College of Computing
801 Atlantic Ave
Georgia Institute of Technology
Atlanta, GA 30332-0280
USA
You can also fax them to 404-894-9846.
Sorry, but we can not accept applications via email.
More information is available at:
http://www.cc.gatech.edu/~asb/moose-crossing/
If you have any questions or problems, send email to:
moose-request@cc.gatech.edu
We're sorry there's so much to do before your child can try MOOSE
Crossing out, but these forms are part of how we try to make MOOSE a
safe place for kids. Thank you for your patience with these
formalities!
-- Amy Bruckman
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KID PART
So you're interested in joining MOOSE Crossing? Welcome!
MOOSE Crossing is a place on the Internet where you can decide to be a tiny
purple bird and build yourself a nest, a giant green blob and build yourself a
space ship, or maybe a munchkin and build yourself a piece of the yellow brick
road. And you can meet other kids from around the world.
MOOSE Crossing is for kids aged 13 and under. Rangers volunteer to help run
MOOSE Crossing. If you are old enough to be a Ranger, see the MOOSE Crossing
General Instructions for information on how to get a Ranger application.
There are two parts to this form: the informed assent form, and the code of
conduct. Please think carefully about what they say, and don't sign them
unless you agree.
INFORMED ASSENT
MOOSE Crossing is a research project of Amy Bruckman and the Georgia
Institute of Technology. You don't have to participate if you don't
want to. You can quit any time if you don't like MOOSE Crossing.
Your parents can also cancel your account at any time.
Almost everything that is typed on MOOSE Crossing is recorded, so that Amy can
study things like how kids learn, and how to make MOOSE Crossing a better
place. Amy won't share these recordings with other people, but will write
about some of them, with the names changed. If you don't want to be recorded,
there are other MUDs for kids that don't record anything.
If you have any questions, email moose-request@cc.gatech.edu and we'll
be happy to help you. If you feel you've been treated unfairly as
part of this research project, we'll be happy to talk with you about
it. Talk to your parents or your teacher, and they can reach Amy by
calling 404-894-9222
I UNDERSTAND:
I understand that MOOSE Crossing is a research project.
I understand that I may quit at any time.
I understand that things are being recorded, and I don't mind.
_____________________________________________
Kid--PRINT Your Name Here
_____________________________________________ ____________________
Kid--SIGN Your Name Here Date
CODE OF CONDUCT
To be a member of MOOSE Crossing, you are expected to be a good citizen. Most
of the rules are just like rules for how to behave in the real world:
* Don't do anything you wouldn't do at recess at school.
* Do unto others as you would have them do unto you.
* Help others whenever you can.
If you think maybe you shouldn't do something, you probably shouldn't. Be
nice to other kids. And help them out. There's lots of stuff to learn on
MOOSE Crossing. People will help you get started, and then you can help the
next new person.
When you join MOOSE Crossing, you will get a secret password. Please
don't tell this password to anyone.
These rules you might not have heard before. They're important:
* Don't tell anyone your home address or phone number.
* Don't meet anyone face to face.
Most people are nice, but there are some people out there who want to hurt
kids. No matter how nice someone seems or how old they are, don't tell them
your home address or phone number or agree to meet with them in person. If
you really really want to meet someone, ask your parents to help you set up a
safe meeting in a public place, and have your parents come with you.
Using MOOSE Crossing is a privilege. If you break the rules, we may
take away your account, and you will not be allowed to use MOOSE
Crossing any more
I PLEDGE:
I won't do anything I wouldn't do at recess at school.
I'll treat others the way I want them to treat me.
I will help others whenever I can.
I won't tell anyone my secret password.
I won't tell anyone my home address or phone number.
I won't meet anyone face to face.
_____________________________________________
Kid--PRINT Your Name Here
_____________________________________________ ____________________
Kid--SIGN Your Name Here Date
To finish your application, we need to figure out which character
is you! Have you already requested a MOOSE Crossing character online?
If so, what character name did you request?
_____________________________________________
Print Character Name Requested
_____________________________________________
Email Address (yours, your parents, or both)
*************************************************************************
This is the kid form. Please print it out. The kid who wants to join
MOOSE Crossing should read it and sign it.
You need three forms:
* Kid form
* Parent form
* Parent questionnaire.
Send them via surface mail to:
MOOSE Crossing Applications
c/o Amy Bruckman
College of Computing
801 Atlantic Ave
Georgia Institute of Technology
Atlanta, GA 30332-0280
USA
You can also fax them to 404-894-9846.
Sorry, but we can not accept applications via email.
More information is available at:
http://www.cc.gatech.edu/~asb/moose-crossing/
If you have any questions or problems, send email to:
moose-request@cc.gatech.edu
We're sorry there's so much to do before you can try MOOSE Crossing
out, but these forms are part of how we try to make MOOSE a safe place
for kids. We hope you'll think it's worth it!
-- Amy Bruckman
*************************************************************************
PARENT QUESTIONAIRE
Thanks for taking the time to answer these questions. The answers will help
us learn more about how kids learn on MOOSE Crossing, and help us better work
with your child. Your answers will be kept strictly confidential.
1. What is your child's full name and age?
2. What sort of school does your child attend? (Public or private?
Any particular philosophy or emphasis? ie. Montessori, Steiner, etc.)
3. Is your child in a special-needs classroom? If so, what kind?
4. Does your child have particular difficulty with any subjects at school?
Explain.
5. Does your child have unusual ability in any subjects at school?
6. Does your child have any other unusual abilities (outside of school)?
7. How does your child relate to other children (shy, aggressive, etc.)?
8. Is there anything else you would like to tell us about your child?
9. What are the occupation(s) of the child's parent(s) or legal guardian(s)?
10. What is the highest level of education attained by each of the child's
parent(s) or legal guardian(s)? (some high school, completed high school,
college, graduate or professional degree, etc.)
*************************************************************************
Please print out this and all other applicable forms, complete them, sign
them, and return them via regular mail to:
MOOSE Crossing Applications
c/o Amy Bruckman
College of Computing
801 Atlantic Ave
Georgia Institute of Technology
Atlanta, GA 30332-0280
USA
You can also fax them to 404-894-9846. Sorry, but we can not accept
applications via email.
More information is available at:
http://asb.www.media.mit.edu/people/asb/moose-crossing
If you have any questions or problems, send email to:
moose-request@cc.gatech.edu
Thank you for your patience with these formalities!
-- Amy Bruckman, MIT Media Lab
*************************************************************************