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During the laboratory that is scheduled to take place at_______________________ on ____________, your child will have the opportunity to conduct an experiment with his/her own DNA. DNA samples will be collected from cheek cells that normally exist in saliva. Students will simply swish their mouth with a saline solution and spit the sample into a cup. The DNA samples that are extracted from these cells will be amplified and examined for specific DNA markers, which may vary from person to person. Please be assured the DNA markers we will examine play no known role in an individual’s health. Alternately, strands of hair (removed by the students themselves) may be used. Student samples will be discarded after completing the experiment.

There is a consensus that human DNA samples should not be obtained without the willing consent of the donor, who understands the purpose for which it is being collected. Thus, these experiments will be explained clearly beforehand, and students will be given the option to refrain from participating.

Please sign below indicating authorization for your child’s participation in this experiment. All participants must present a permission slip before taking part in this laboratory.

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Name of Student please print	Name of Teacher please print

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Name of Parent/Legal Guardian please print	Parent or Guardian Signature	Date