Videotape Release Form

from Usability.gov + mashups.

I, the undersigned, agree to participate in the study conducted and videotaped at The Open Planning Project. 
 
I understand and consent to the use and release of the videotape by The Open Planning Project.  I understand that the
information and videotape is for research purposes only and that my name and image will not be used for
any other purpose. I relinquish any rights to the videotape and understand the videotape may be copied
and used by The Open Planning Project without further permission. 
 
I understand that I can leave at any time.
 
I agree to immediately raise any concerns or areas of discomfort with the study administrator.

Your signature:____________________________________________________   
 
Date:______________________________________________________________ 
 
Please print your name: ______________________________________________
Address: __________________
City and State: ________________
Phone Number: __________________

 


Thank you!
 
We appreciate your participation.
 

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Test User Consent Form

Dear __________,

Thank you for coming today! We are having you test a game called Journey Into The Brain. We would like to ask you to play the first level of the game, which we expect you can do in an hour or less. We'd like you to try to describe out loud what you are thinking as you are playing. If you get really stuck or have a question, we'll help you, but try to figure out the game as best you can. You are free to stop at any time, though we ask that you try to finish level one. Your participation is very valuable and will help us to suggest improvements for the game.

At the end of the hour, we'd like to ask you a few questions and get your impressions of the game. This is to test the game, not you. Your answers and name will be kept confidential.

We need your permission to video tape your user experience. The tapes help us take notes on your actions and reactions. We would also like to show parts of the tapes to our classmates and teacher. We will not show them for any other reason without asking your specific permission.

Thank you!
Pauline Brutlag and Keli Sato

If you agree to the above conditions, please fill out below:

Print Name: ___________________
Sign Name: ____________________
Signature Date: _________________

Address: __________________
City and State: ________________
Phone Number: __________________