AP Psychology Southmoore High School Miracle Berry/ Gymnema Sylvestre Taste Lab Permission Slip

Student Name (print) ______Grade______

Parent Permission: I give my son/daughter permission to participate in the Miracle Berry Taste Lab in AP Psychology class at Southmoore High School. I understand that this lab involves consuming a “miracle berry” or Gymnema Sylvestre followed by tasting very small amounts of various food, seasonings, and beverages. I understand that the school is not liable for any allergic reactions my child has to any of the involved substances involved in the lab including: miracle berries, salt, sugar, lemon, coffee, vinegar, beef broth, potato chips, cookies, seasonings, and/or pickles,.

This permission slip is due (signed by a parent or guardian) on the day of the lab or participation in the lab is not allowed.

Important information  A signed parent permission slip is mandatory for participation in the lab  This lab will be supervised by Ms. Blevins in a safe and clean environment  “Miracle berries” are tabs of freeze dried fruit (“miracle fruit” aka Synsepalum dulcificum)  The berries have a low sugar content and a molecule called “miraculin” which when bound to the tongue’s taste buds cause sour foods to taste sweet, and alters other flavors as well  Gymnema Sylvestre is a woody climbing shrub most often, today, consumed as a tea or in pill form.  Gymnema Sylvestre is used to prevent the absorption of sugar and when used to coat the inside of the mouth can cause sweet foods to have no flavor.  Gymnema Sylvestre might lower blood sugar

Parent/Guardian Information

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Date: ______

Parent Contact Phone Number(s) ______

Emergency Contact Information

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