PARENT MM video image consent

Parent / carer consent form for MindMate Leeds

Your child has asked to take part in a MindMate Leeds project which involves sharing images or video content of your child on MindMate social media platforms and the MindMate website.

This project aims to help raise the profile of positive mental health amongst children and young people in the city of Leeds.

We need your consent to say that you agree for your child to take part in this activity as outlined on this webpage which your child has signed .

Please read the information set out on the link above before giving your consent below. Fill in your details below and tick the boxes below to say you give consent for your child to take part.

Your name

Email address or mobile phone number

Name of child

Date of birth of child

Tick the boxes to give your consent

1.I am happy for MindMate Leeds to publish images which feature my child.

2. I am happy for MindMate Leeds to publish videos which feature my child.

3. I agree that what my child says may be used in written resources to support the MindMate campaign

4. I am happy for Common Room to gather recordings and images of my child for the purposes outlined on the child consent page.

5. I understand that once materials have been published or entered the online public domain it is impossible to fully retrieve them.

6.I understand that I can withdraw my permission at any time via Common Room.

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.

What next?

If you have any questions about any of the above please contact liz.neill@commonroom.uk.com.

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