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25-084249-01 UK & USA Culture & Nutrition_CHILD Consent Form

UNDER-16s PHOTOGRAPH/FILMING CONSENT FORM

Thank you for your interest in allowing your child to take part in this research, which is completely voluntary. If they do take part, and if you give us your explicit consent, video and audio recording and/or photography of your child taking part will take place. These recordings and photographs may be used in private presentations of the research findings to Ipsos staff and stakeholders and the staff, stakeholders and creative agency partners of The Study Sponsor for research, insight and training purposes. Please note that we may also store the photographs and recordings on our, or our subcontractors’, systems that will be hosted outside the European Economic Area.

Please note that when Ipsos UK is obtaining information from you or your child during the research, Ipsos UK might collect special categories of personal data about your child (including information you or your child may choose to share concerning their racial or ethnic origin, political opinions, religious or philosophical beliefs, health or sexual orientation). If we capture any special categories of personal data relating to your child, we will process that data under your explicit consent. Ipsos UK might, with your explicit consent, share this information with The Study Sponsor, if this information fits the purpose of this research.

Please be assured that any research recordings and photographs will be held by Ipsos UK and The Study Sponsor in strict confidence solely for the purposes described above and will be securely destroyed once they are no longer needed.

If you are happy for your child to take part, and for the video and audio recordings and/or photographs to be used in this way, please read the below, complete the tick boxes as appropriate, and provide your signature and details.

The research has been explained to me, and I have been given a full explanation about the possible uses of any video and audio recordings and/or photographs of my child arising from this research. I have also been given a copy of the project’s privacy notice. I consent to my child taking part in the research.		Yes No
I consent to the video and audio recordings and/or photographs of my child being shared with and used by The Study Sponsor for the purposes described above.		Yes No
I understand that this research might involve the collection of special categories of personal data (such as information I or my child may choose to share about their racial or ethnic origin, political opinions, religious or philosophical beliefs, health or sexual orientation), and I agree to Ipsos UK recording and processing this information about them.		Yes No
I consent to special categories of personal data being transferred to The Study Sponsor, where this information fits the purpose of this research.		Yes No
Are you happy for Ipsos to re-contact you and your child regarding this research?		Yes No
Are you happy for your child’s first name to be included in a caption with the video and audio recordings and/or photographs?		Yes No
Print your full name
Print child’s name
Your relationship to child (or role)
Date
Address
Telephone number
Email address
Please retain for future reference: If you have any questions, please call contact Ipsos UK Ethnography on +44 (0)20 3059 5000 or at [email protected] and quote: 25-084249-01 UK & USA Culture & Nutrition.

Consent of Young Person (10-15 Years Old) (Parent/guardian must complete the section above.)
The project has been explained to me and any questions I may have were answered. I also know that I do not have to take part if I don’t want to. I would like to take part and understand that any video or audio recordings and/or photos taken of me may be used as part of the research findings. I know that this may include video or audio recordings and/or photos being used in private presentations of the research findings by Ipsos UK and The Study Sponsor. I am happy for video and audio recordings and/or photos of me to be used for this project.
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March 12, 2026 4:08 pm BST

25-084249-01 UK & USA Culture & Nutrition_CHILD Consent Form Uploaded by Valeria Ordaz - [email protected] IP 2.126.162.21

March 12, 2026 4:12 pm BST

Val O - [email protected] added by Valeria Ordaz - [email protected] as a CC'd Recipient Ip: 212.42.190.49