Media and Co-production Consent Form

My Life, My Voice

Saying yes or no to taking part, photos and videos

You are invited!

DS Cheshire and Learn and Thrive are making new videos and resources together.

The project is called My Life, My Voice.

Learn and Thrive is a charity. We make free resources about friendships, relationships, bodies, staying safe and feeling good.

We want to know what you think. Your ideas will help make the resources. They will be used by thousands of young people across the UK.

What will happen?

Your DS Cheshire staff will run the sessions, like they always do.

The Learn and Thrive team will visit some sessions.

Staff will ask what you think and write down your ideas.

DS Cheshire will share your ideas with Learn and Thrive.

Staff may take photos and videos.

We might ask if you want to help again later. You can say no.

It is your choice

You do not have to say yes.

You can say yes to taking part and no to photos and videos.

If you say no, you can still come to DS Cheshire. Nothing changes.

You can change your mind at any time. You do not have to say why.

If you don’t want to be filmed on the day, tell a member of staff. They will stop.

Getting help to decide

You can ask someone you trust to read this form with you.

You can ask us questions.

People can help you decide. The choice is yours.

Who we are

Learn and Thrive, charity number 1195053, Office 2, Dragon Coworking, 7-8 New Road Avenue, Chatham, Kent, ME4 6BB

DS Cheshire, charity number 1192916, Denton House, Denton Drive, Northwich, CW9 7LU

Both charities look after the information on this form. Each charity is responsible for how it uses it.

How you complete this form will depend on the age of your young person:

• Under 16: Your parent or guardian gives consent. We also ask you to consent, and a no from you is a no.

• 16 and 17: You give consent. Your parent or guardian signs to say they support the decision.

• 18 and over: You give consent. If feel you can’t make this decision, or don’t have the capacity to make this decision, even with support, or the people who know you well then the parent, guardian or carer with the appropriate level of delegated authority completes Section 1 to tell us what you believe the young person would want, and we will only use images where the young person is happy to be filmed and shows no reluctance or distress.