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Project Information:

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Project Title:

Category:

Project Abstract:

Student Information:

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Student 1:

Student Info:	Parent Info:
First Name: Last Name: Email: Phone: Grade:	First Name: Last Name: Email: Phone:

Student 2 (OPTIONAL):

Student Info:	Parent Info:
First Name: Last Name: Email: Phone: Grade:	First Name: Last Name: Email: Phone:

Student 3 (OPTIONAL):

Student Info:	Parent Info:
First Name: Last Name: Email: Phone: Grade:	First Name: Last Name: Email: Phone:

Safety Questions: (REQUIRED)

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Human Test Subjects (ex: survey, taste test, play a game, or interact with in any way)

A copy of the surveys or tests you intend to use must be attached. Additional project review required. During the review, if it is determined that there is more than minimal psychological or physical risk to the human subjects involved in the project, the student must receive written consent from each of the participants and written parental consent for students under 18 years old, signature pages MUST be included with registration form. If it is determined that there are unacceptable risks involved the student must revise his or her project.

Required Signatures: Science Teacher AND a Psychologist, Medical Doctor, or Registered Nurse
Applies to this Project? Yes No

Non-Human Vertebrate Animals (ex: fish, rabbits, dogs, etc.)

Experiments involving laboratory animals (rats, mice, hamsters, gerbils, rabbits, etc) cannot be conducted in a student’s home except for behavior studies on pets. Proper animal care must be provided daily, including weekends, holidays and vacations. Experimental procedures that cause unnecessary pain or discomfort are prohibited. Experiments designed to kill vertebrate animals are not permitted. Experiments with a death rate of 30 percent or higher are not permitted. Behavioral studies or supplemental nutritional studies involving pets or livestock may be done at home.

Required Signatures: Science Teacher AND a Veterinarian or other Biomedical/Biological Scientist
Applies to this Project? Yes No

Bacteria, Mold, Fungi, Viruses or Parasites, Human or Animal Fresh Tissues, blood or body fluids, etc. (Potentially Hazardous Biological Agents)

Determine the level of biological containment available to the student researcher. Biosafety Level 1 projects can be performed in a school BSL-1 laboratory but are prohibited in the home environment. Bacteria, mold, fungi or any other potentially hazardous biological agent CANNOT be cultured at home. Standard microbiological practices must be used and all hazardous agents must be properly disposed of at the end of experimentation. The experiment must be supervised by a qualified scientist or a trained designated supervisor. For lab space or questions, please contact the Central Utah STEM Fair Office, admin@cusef.byu.edu or 801-422-1987

Required Signatures: Science Teacher AND a Biomedical/ Biological Scientist
Applies to this Project? Yes No

Prescription or Over the Counter Drugs, Alcohol, Tobacco

Students must adhere to all federal, state and local laws when acquiring and handling controlled substances. Only under the direction of a qualified scientist or designated supervisor may a student use federally controlled or experimental substances for therapy or experimentation. Students under 21 may not handle or purchase smokeless powder or black powder for science projects.

Required Signatures: Science Teacher AND a Biomedical/ Biological Scientist
Applies to this Project? Yes No

Hazardous Chemicals, Weapons/Firearms, Lasers, Radiation, etc.

Students must adhere to federal and state regulations governing hazardous substances or devices. An adult must directly supervise the experiments. Students working with hazardous substances or devices must follow proper safety procedures for each chemical or device used in the research.

Required Signatures: Science Teacher AND a School Administrator
Applies to this Project? Yes No