Consent and Release Form
By signing this form, you give the BRIDGE-In Agriculture Program (which term is deemed to include all parties engaged in connection with the Program) and Mastercard Foundation (the “Foundation”) permission to mention, refer to, and use information about and recordings of you publicly in connection with the BRIDGE-In Agriculture Program and the associated mission as detailed further below.
You hereby consent for the BRIDGE-In Agriculture Program and the Foundation to collect and use:
- Interviews, videos and photographs of you, including recordings of your voice.
- Your personal data, which includes:
- Your first and last name;
- Your location (village/town, district, and country);
- Your occupation;
- Your contact details;
- Your age;
- Your date of birth; and
- Your address.
- Data on the nature of support from The BRIDGE-In Agriculture Program and the Foundation; and
- Quotes from interviews, videos and recordings of you.
You confirm you have provided this data willingly and with an understanding of how it will be used, shared, stored and otherwise dealt with.
Use of Information:
You further consent to use of the data in connection with the following purposes:
- Research, Learning, Data Verification, Impact Monitoring, and Evaluation Studies:
Your personal data will be securely shared by the BRIDGE-In Agriculture Program with the Foundation for the purposes mentioned and other related studies which may be carried out directly by the Foundation or by third-party Research, Learning and Impact Partner Organizations as required for the Foundation’s purposes.
The Foundation will, where required, submit your anonymized data to its Research, Learning and Impact Partner Organizations, who will conduct the data verification and relevant studies on behalf of the Foundation. If you are ultimately sampled for such activities, your personal data will be shared with these organizations who in turn will seek your consent for the specific activity, for example, data verification or evaluation studies.
- Marketing Communications:
This content may be used by BRIDGE-In Agriculture Program and/or the Foundation for marketing purposes, including communicating the success of BRIDGE-In Agriculture Program and/or the Foundation’s programs as well as sharing learning with the broader international community. You agree that BRIDGE-In Agriculture Program and the Foundation can use the information collected from you on our and/or the Foundation’s websites, the internet, on social media, in publications, photographs, print media, videos, documentaries, and podcasts. You agree that the Foundation does not need your further permission or approval when posting such material and you expressly waive any legal claims related to such use, including claims relating to copyright or rights of publicity or privacy.
Free and Willing Consent:
You are not obligated to give us your consent, nor do you have to tell us anything that you are not comfortable communicating publicly or being used for research, learning, data verification, Impact monitoring, evaluation purposes.
We want to tell your story and represent you in a way that is respectful and dignified. We also want to use your information and insights to assess the Impact of our goal to enable young women and men in Ghana to secure employment they see as dignified and fulfilling, and for continuous enhancement of Foundation supported programs.
You will not be rewarded or penalized in any way for your consent or non-consent to this data sharing request. If you have any questions or concerns about your consent or the use of your information, please do not hesitate to ask a representative of the BRIDGE-In Agriculture Program before signing this form. If you do not understand the impact of this form, please seek additional information and explanation from the same representative.
You can withdraw your consent or ask questions about the use of the content at any time by emailing Doreen Osado-Parry at doreen.osafoparry@crossboundary.com. You understand that such withdrawal or revocation of consent will not affect any actions or processing activity undertaken before the receipt of this written notification.
The BRIDGE-In Agriculture Program and Mastercard Foundation have put in place security measures to protect the integrity and accuracy of the personal data. The information collected will also be retained and kept as long as they are relevant and after that time, destroyed or archived.
For additional information on how The BRIDGE-In Agriculture Program and the Foundation processes personal data, please visit The Mastercard Foundation Privacy Policy to access a copy of its privacy policy.
The Foundation’s privacy policy can be accessed via https://mastercardfdn.org/privacy/.
By clicking “Accept” in relation to this form, I confirm that, notwithstanding the absence of my signature:
- I am over 18 years of age, or if I am under 18 years of age, this form has been completed by my parent or guardian on my behalf, who has explained the contents and implications of the form to the minor.
- My consent is given freely and I have had an opportunity to decline to participate.
- I have read and understood this form and consent to the collection and use of the information described, or if I cannot read, someone has read and explained the contents of this consent to me.
- I release The BRIDGE-In Agriculture Program, those engaged to execute it and Mastercard Foundation from all claims of any kind that I or my heirs, executors, administrators, legal representatives, successors or assigns ever had, now have, or may in the future have, arising from, connected with, or in any way related to the collection or use of the information described.
By checking this box, you are electronically signing and confirming that you agree to the terms of Consent and Release Form.
