Consent and Release Form

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INFORMED CONSENT AND RELEASE

 

Project Title: Project Mumbo – Video Data Collection 

Project Lead: Kristy Mueller – Kmueller@appen.com 

 

OVERVIEW

This is a data collection project undertaken by APPEN BUTLER HILL PTY LTD

(“Company”). Your decision to participate in this project is completely

voluntary and not a requirement or expectation of your job. If you decide to

participate, it should be during your personal time. You may decline to

participate or stop your participation at any time. The results of this study may

be used to develop and improve products and services, such as technologies and

algorithms that operate on images, video, and/or depth data. These could include

machine learning, algorithms and other technologies for focusing, color, contrast,

classification and recognition, image processing, and immersive multi-media.

 

PROJECT SPECIFIC DETAILS

WHY IS THIS PROJECT BEING DONE?

The purpose of this study is to collect videos of people within the context of their environment (“Project Data”).

 

WHAT WILL HAPPEN IF I TAKE PART IN THIS RESEARCH PROJECT?

Intake / Receipt of Instructions (5-10 minutes):

• Before you begin your data collection, you will be provided with this Consent

and Release Form or “Consent”, which explains what data you will be asked

to collect and why. Please review this Consent and Release Form carefully

and feel free to ask questions.

• A representative from the Company may provide you with additional

instructions regarding what documents and/or objects to collect and how to

capture the video of that document and/or object and provide it to

Company.

 

Video Capture (1.5 to 2 minutes):

• You will be asked to perform a minimum of 1 to a maximum of 4 selfie videos emulating a Facetime conversation (each 1.5 – 2 minutes long) in different environments (indoors, outdoors) at different times of the day (morning, afternoon, evening and night)

 

 

WHERE WILL THIS PROJECT TAKE PLACE?

You can record the video in any setting in which you feel comfortable, so long as the

video only captures you participating in the activity, per the

directions you receive. No features of other persons (including image)

should appear in the video. Other than your own facial features, no personal

information that could identify you or the other participants (eg readable address or

name) should appear in the video.
 

HOW LONG WILL MY PARTICIPATION IN THIS PROJECT TAKE?

This project should generally take you between 10  - 15 minutes, depending on

the number of tasks you perform.

 

WHO CAN PARTICIPATE IN THIS PROJECT?

You must be 18 years old or over to participate in this project. If an individual under

the age of 18 years old is participating in this project, written consent from the

individual’s parent/legal guardian must be obtained.

 

WHAT DATA WILL BE COLLECTED?

As part of this project, the information collected from you may include the following

(we call this “Project Data”):

· Contact Information: Worker ID (anonymous randomly assigned ID unique to each

worker)

· Video: Video of your head, neck and shoulders

· Documented Project Data: Gender, Birth Year, Race/Ethnicity and Skin Color

 

PROJECT DATA AND PERSONAL INFORMATION

Project Data may reflect the image, likeness, voice, and other general characteristics

of you and others. By signing this Consent, you agree to allow Company and external

entities that Company chooses to collaborate with (subject to appropriate

contractual obligations) to collect, use, store, process, and disclose your personal

information for the purposes described in this Consent and in connection with the

project. If you are the parent/legal guardian of a person under the age of 18 years

old who is participating in this project, you agree to allow Company and external

entities that Company chooses to collaborate with to collect, use, store, process, and

disclosure the minor’s personal information for the purposes described in this

Consent and Release and in connection with this project. To the extent that you

provide Company with the personal information of other persons in connection

with your participation in the project, you represent that you will obtain all consents

required to provide Company with the rights necessary to collect, use, store, process,

and disclose their personal information as described in this Consent.

 

YOUR RIGHTS IN PERSONAL INFORMATION

Company is collecting Project Data on behalf of the Study Sponsor. Company may

disclose Project Data to the Study Sponsor for use consistent with this Consent and

Release Form. The Study Sponsor and Company may retain third parties to collect,

process, and analyze the data on their behalf. Study Sponsor may retain deidentified

data, analysis, models, algorithms, learning and work product obtained,

trained on, or otherwise resulting from use of Project Data.

If you decide to participate, you have the right to request access to Project Data and

the right to request to have any such data rectified, completed, blocked or deleted.

You also have the right to subsequently object to the collection of any such data and

revoke your consent at any time. Please submit such a request or revoke your

consent through your Project Lead. Your request will then be passed on to the Study

Sponsor.

If you decide to participate in the project, you have the right to access any data

collected about you as part of this project and the right to have any such data

corrected, completed, blocked or deleted. You also have the right to object to the

collection of any data and withdraw from the project at any time. To exercise any of

your rights or to raise questions on the use of your data within this project contact

the Project Lead.

 

YOUR REPRESENTATIONS

You represent that the Project Data videos submitted by you are original to and

owned by you, if applicable, and that you have full authority from any individuals

depicted in the Project Data videos to provide them to Company pursuant to the

terms of this Consent. You agree to release Company, its agents, employees,

licensees and assigns from any and all claims you may have now or in the future for

invasion of privacy, right of publicity, trademark infringement, copyright

infringement, defamation or any other cause of action arising out of Company’s use

of the Project Data videos submitted by you. You understand and agree that

between Company and you, Company is and shall be the exclusive owner of all right,

title and interest, including copyright, in any works that may be created by Company

containing the Project Data, subject to pre-existing rights in any of the Project Data.

 

USE, DISCLOSURE, AND DELETION

Any information that you provide to Company in connection with the project,

including the Project Data, will be kept Confidential. The Project Data may be used

by Company, Study Sponsor, their personnel, and third party vendors or business

partners subject to appropriate contractual obligations, for the purposes described

in this Consent. Project Data may also be provided to public, regulatory, or

government authorities, including law enforcement, when required by law, legal

process, or litigation.

Any Project Data containing personally identifiable information, including

identifiable image or voice data, that you provide to Company in connection with the

project, will be deleted will be deleted within 10 years of the date of this Consent

and Release. Project Data that does not contain personally identifiable information,

including where such information has been blurred or similar, may be continued to

be retained. You may contact the Project Lead at any time to request deletion of

your personal information and reasonable efforts will be made to delete your

personal information within a reasonable amount of time; however, note that in

some circumstances, deletion of your personal information may not be feasible.

 

WHAT RISKS OR DISCOMFORTS SHOULD I EXPECT FROM PARTICIPATING IN

THIS PROJECT?

This project does not pose any known risks. There may additionally be some

unknown and unforeseeable risks.

WITHDRAWAL: You may decline to participate or stop Your participation in the

project at any time by providing written notice to the Project Lead. Company may

continue to use the videos that you provided to Company prior to your withdrawal

unless you request that it be deleted as described above, in which case it will be

deleted where feasible.
 

CONFIDENTIALITY OBLIGATIONS

By agreeing to participate in the project, you acknowledge that any information

about the project, including any project details or the fact of your participation, are

considered Confidential Information and are covered by the obligations under your

agreements with Company.

 

What are My Confidentiality Obligations?

If you agree to participate in the study, you must also agree to not disclose any

information from or about the study with anyone, without first obtaining approval

from the Project Lead.

 

What is Considered Confidential?

The fact that the Company is conducting this study, the types and methods of data

collection, and any other detail about the study or how it is conducted are

confidential. Any information that you learn about the study, including technical

information and the identity of the personnel in the study or working on the study,

and any other information identified as non-public information is considered

confidential and proprietary information that belongs to the Company or Study

Sponsor and must not be disclosed by you. This includes before, during, and after

you participate in this study. You may not use any cameras, video recorders or other

electronic storage devices to record Confidential Information at any time.

 

Who Needs to Know?

Do not assume that anyone, including other Company employees, knows

information about the study. Most Company employees do not know about this

study. Do not talk to anyone about the study unless you are authorized in writing to

do so by the Project Lead. It is of utmost importance that no confidential

information be communicated to anyone, in any manner, outside of Company, study

personnel or Project Lead, including friends, family members, professional

colleagues, and especially, the press. You may not discuss or display any

Confidential Information in any form, including via phone, electronic

communications or social media.

 

Take Precautions To Avoid Inadvertent Disclosure.

You will not be permitted to take any photographs or videotape anything related to

the research study. When communicating with the study personnel, make sure you

are in a private location.

Failure to maintain the confidentiality of information may seriously harm the study.

If you become aware of any unauthorized disclosure of confidential information,

please report it to study personnel or Project Lead immediately.

If you have any questions that are not addressed here, please discuss with study

personnel or Project Lead.

 

What are Company’s Enforcement Rights?

You hereby acknowledge that unauthorized disclosure or use of Company

Confidential Information could cause irreparable harm and significant injury to

Company that may be difficult to ascertain. Accordingly, you agree that Company

will have the right to seek and obtain immediate injunctive relief to enforce the

confidentiality obligations under this Consent and Release, in addition to any other

rights and remedies Company may have.

 


STATEMENT OF CONSENT

 

Your signature on the main application form is your acknowledgement of the following:

 

• I have read and understand this Consent and have received answers to my

questions.

• I am voluntarily signing this Consent indicating that I consent to participate

in this study.

• I agree that I will keep confidential all information disclosed to me during the

study.

• I grant Company and the Study Sponsor the right to collect, use, process,

store, and disclose Project Data as described in this Consent.

• I understand that I can receive a copy of this Consent form upon request.

 

WHO CAN ANSWER MY QUESTIONS ABOUT THE PROJECT?

If a project-related problem should occur, or if you have any questions about the

project at any time, please contact the Project Lead listed above.

 

CONSENT AND RELEASE

You acknowledge that you have read this consent carefully, that you understand and

agree to all of its terms.

 

You understand that you may ask for a copy of this Informed Consent and Release

Agreement.

 

 

CLOSE THIS WINDOW AND RETURN TO THE MAIN APPLICATION FORM TO SIGN

 

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