Republic of the Philippines

Department of Education
Region V (Bicol)
SCHOOLS DIVISION OF LEGAZPI CITY
LEGAZPI CITY SCIENCE HIGH SCHOOL
Bitano, Legazpi City

Student Researcher(s): Eddie Kim Caño, Anna Mae Belaza, Trisha Bitara, Joanna Bongadillo,
Adeline Joy Reales
Title of Project: Effect of Utilizing Games in Improving Students Learning Performance in
Science Concepts- A Case of “Fill Me Up”
I am asking for your voluntary participation in my science fair project. Please read the following
information about the project. If you would like to participate, please sign in the appropriate area
below.
Purpose of the project: To create a science-based game for teaching to lighten up the
atmosphere inside the classroom and provide icebreaker while learning the concept of
conductivity and any desired topic

If you participate, you will be asked to: Play the game created by the researchers and also
answer the pre-and post-test questions and the survey questionnaire

Time required for participation: 1-2 hours

Potential Risks of Study: None

Benefits: The study will promote interactive and fun learning and application of knowledge
through playing game cards challenge students’ minds to think and become strategic approaching
game scenarios and consequences.

How confidentiality will be maintained: The answers from the pre-and post-test questions and
the responses from survey will only be viewed by the researchers conducting the study

If you have any questions about this study, feel free to contact:

Adult Sponsor/QS/DS: Mr. Sonny A. Jacob Phone/email: ______________________

Voluntary Participation: Participation in this study is completely voluntary. If you decide not
to participate there will not be any negative consequences. Please be aware that if you decide to
participate, you may stop participating at any time and you may decide not to answer any
specific question.
By signing this form, I am attesting that I have read and understand the information above and I
freely give my consent/assent to participate or permission for my child to participate.

Adult Informed Consent or Minor Assent Date Reviewed & Signed: __________________

_____________________________________ ______________________________________

Research Participant Printed Name: Signature:

Parental/Guardian Permission (if applicable) Date Reviewed & Signed: ________________

_____________________________________ ______________________________________

Parent/Guardian Printed Name: Signature: