Consent form for MindMate Leeds - digital images/video recordings
Thank you for agreeing to take part in a video/ audio recording or photo shoot in relation to MindMate Leeds. This will help us raise the profile of children and young people's mental health in the city. This involves sharing images or video content of you on MindMate social media platforms and the MindMate website.
Anonoymity
We will keep your personal information and any contact details we have for you confidential- we will not share your date of birth, where you live or contact details with anyone outside of Common Room. We may share details such as age and general location [e.g. Leeds, LS7] Please note that because the content we are gathering today will go on line there is not way of protecting your anonymity and how this gets shared.
Safeguarding
Common Room takes safeguarding its participants seriously and has a
safeguarding policy which all staff work to. As part of this policy, we work to the following confidentiality statement.
Storage of personal data
These full recordings and images will be securely stored by Common Room for a period of up to 6 months when they will be deleted (unless required for safeguarding investigations). You have a right to remove your consent at any time in this period.
What next?
If you have any questions about any of the above please contact liz.neill@commonroom.uk.com.
We need your consent to say that you agree to take part in this activity as outlined above.
Please fill in your details below and tick the boxes below to say you give your consent to take part.
If you are under 16 years old please also ensure your parent/guardian completes the parent form below.
Common Room Confidentiality Statement
Common Room offers confidentiality to children, young people and adults we engage with through our work, including staff members. This means we will not normally share information about you to anyone outside the organisation without your agreement. We will keep information about you secure only until it is no longer needed and share this on a need-to-know basis.
There may however be times when we need to share information about you with external partners or organisations when we are concerned that you or someone else are in danger or at risk of significant harm. Wherever possible we will try to discuss this with you and gain your consent before giving out any information. However, if we are unable to do this and feel that telling you would increase the risk, we may choose to do so without your consent.
If you are unsure or would like to know more about the above, please ask one of the workers or email liz.neill@commonroom.uk.com
