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2019 Black Rock City Census

Consent Form

Online Consent Form

Research Title: 2019 Black Rock City Census

Principal Investigator:     
Dominic Beaulieu-Prévost, PhD             
Phone: 1-514-987-3000 #4211

Partner Organization: Burning Man Project

Project Description: This survey is for individuals who attended Burning Man this year and are at least 18 years old. The questions in the following survey will ask about your experiences in Black Rock City, your thoughts about Burning Man and related topics. The results of this survey are distributed in reports on the Burning Man website, at the Census Lab in Black Rock City, and in academic publications. The information is also used by the Burning Man organization to improve the event and to better represent the interests of the people of Black Rock City in negotiations with authorities in the state of Nevada and the US federal government. The study is being conducted for the Université du Québec à Montréal by Dominic-Beaulieu-Prévost, Ph.D.  The project is being supervised by Dominic Beaulieu-Prévost, Université du Québec à Montréal, Montréal (Québec), Canada, 1-514-987-3000 #4211,

General Study Procedure: For this study, you will be asked to complete an online questionnaire that will take approximately 30 to 60 minutes. 

Risks: There is no expected risk associated with this study. 

Benefits: There is no direct benefit associated with participation in this study. This study is designed for the researchers to learn more about people’s thoughts and experiences in regards to Burning Man. This study is not designed to treat any illness or to improve your health. 

Costs/Compensation: There is no cost or compensation for your participation in this study, we only thank you for your time! 

Study Withdrawal: Your participation is voluntary. If you choose to take part, you have the right to stop at any time.  You may choose not to answer any question or end all participation in the study at any time without any prejudice against you.  

Invitations for Questions: Please feel free to ask any questions about this study or this consent form, either now or in the future, by contacting Dominic Beaulieu-Prévost at 1-514-987-3000 #4211 or Dominic Beaulieu-Prévost is a professor at the Department of Sexology at Université du Québec à Montréal (UQAM). The Institutional Ethics Committee for Research with Human Participants of the university approved this project. If you have any concerns or questions about the study that cannot be addressed by the main researcher, please contact the coordinator of the committee at 1-514-987-3000 #7753 or If you have any complaint to make, please contact the Ombudsman at UQAM at 1-514-987-3151 or  

Confidentiality: All information collected in this survey will be kept strictly confidential, except as may be required by law. Confidentiality is strictly maintained; data collected during this study is coded and stored by number. To maintain your confidentiality we will never ask you for your name. Also, only group results will be released for publication. Further, research assistants and collaborators involved in this project have signed a confidentiality statement. All responses will be kept on a secure website. All records (stored by participant number) will be kept indefinitely. Data will cross electronically the USA/Canada border and, according to the Patriot Act, could be intercepted by the USA authorities. However, data will be encrypted before transfer and will not include identifying information such as IP addresses. 

1. AUTHORIZATION: I have read this information about the study. I understand the possible risks and benefits of this study.  I know that participation in this study is voluntary. I choose to be in this study. By clicking at the bottom of this screen, I agree to participate in this study and I understand that I may withdraw my consent at any time without any prejudice against me. *This question is required.
2. Additional authorization for a secondary use of the data (optional) *This question is required.Do you agree for the data that you provide to be used for secondary analyses by an external researcher? If you agree, we could allow access to relevant data to a researcher outside of the Black Rock City Census Lab who submits a scientific project that we did not originally plan. The same level of confidentiality would still prevail and such project would be done in collaboration with the Black Rock City Census.