How to Love Yourselfie Consent Form

Purpose of Workshop

Deepen your understanding of the media and its promotion of specific ideals of beauty.

What will I be asked to do?

By participating in this program, you will be asked to watch and listen to five short videos (a total of 45 minutes), answer prompts associated with each video, and then fill out a short questionnaire about your experiences and reactions.

What are the risks?

We believe the risks are minimal. Nevertheless, if you find that answering any specific questions causes you concern or distress, you may skip it. If you find that several questions are distressing, communicate this to your workshop or program facilitator.

What are the benefits?

You may experience no direct benefits. However, it is possible that you learn things about media and beauty ideals that change how you think, how you react to social media messages, and some of your personal attitudes.

What if I want to withdraw from the workshop?

Participation in this workshop is completely voluntary. You are free to pause or stop at any time. If you have any questions, strong concerns or complaints about this program please contact the facilitator presenting this program to you. It could be at a school, a facility or small group setting. You will have been given the necessary information prior to starting the workbook and feel free to email Breaking The Chains Foundation at Iambreakingthechains@gmail.com

Thank you very much for your participation!

Participants 17 years and younger, please have a parent/guardian sign/accept below.