Stay ChatTY Schools Program Information Sheet and Consent Form

    SPEAK UP! Stay ChatTY aims to promote positive mental health and reduce suicide by raising awareness and encouraging people to seek help. It was founded after Mitch McPherson lost his brother to suicide in 2013.

    Stay ChatTY Schools Program

    The Stay ChatTY Schools Program (the Program), with Relationships Australia Tasmania Incorporated (RA Tas), uses evidence informed training to have conversations about mental health and suicide with young people.

    The Program content focuses on:

    • demonstrating that even resilient people show their emotions, and that feeling sad, scared or anxious is normal when going through a tough time

    • increasing understanding of the importance of seeking help and knowledge of where to go for help

    • encouraging participants to think objectively about how to look after both themselves and their peers

    • increasing confidence in talking about mental health and providing support to others

    Support services

    During and or after the Program, if you or your child require support, you can contact RA Tas for counselling services on 1800 364 277, or discuss any concerns with teachers and support staff at the school.

    If you or your child require immediate support:

    School

    Please select the school your child attends.

    Participation

    Consent to participate

    I, (Parent/guardian’s name/s)

    (Parent/guardian’s email address)

    provide consent for (Child’s name)

    to participate in the Stay ChatTY Schools Program.

    • I have read and understood the purpose of the Program

    • I understand that my child may participate in this activity, realising that I, or my child, may withdraw from the Program at any time.

    • I am aware of support services available to me should my child or I require additional support before, during or after their participation in the Program.

    Parent/guardian signature - please tick below to sign this document

    Personal information collection

    RA Tas may collect de-identified information from you or your child for the purposes of running, evaluating and promoting the Program, or for research and statistic purposes.

    Any personal information is managed in accordance with RA Tas’ Privacy Policy, which is available for download here, the Fact Sheet can be downloaded here The Privacy Policy includes information on how to access and correct you or your child’s personal information, as well as information on how to make a complaint if you feel you or your child’s privacy has been infringed. RA Tas respects your privacy and is committed to ensuring personal information, is managed in accordance with the Australian Privacy Principles as contained within the Privacy Act 1988 and the Personal Information Protection Act (2004).

    Personal information collection

    I, (Parent/guardian’s name/s)

    provide consent for de-identified information about (Child’s name)

    to be collected as part of the Stay ChatTY Schools Program.

    • I have read and understood the personal information collection information.

    • I understand that de-identified data will be gathered for the Program and may be published.

    • I understand that additional consent will be requested from me and my child if identifying information about my child is requested to be published.

    • I understand that I can obtain information about RA Tas’ handling of my or my child’s personal information in the RA Tas Privacy Policy, available on the RA Tas website.

    • I understand that if my or my child’s personal information is to be used for any other purpose other than that set out in this document and the RA Tas Privacy Policy, my written consent will be obtained.

    • I consent to RA Tas handling my and my child’s personal information for the purposes set out in this document and in RA Tas’ Privacy Policy.

    Parent/guardian signature - please tick below to sign this document

    Photography/videography collection

    RA Tas staff or a media representative may take photographs or video footage of Program participants for the purposes of social media, promotion or research. This material may appear in printed or electronic form and may be available to a global audience via the internet.

    Consent to photography/videography

    I, (Parent/guardian’s name/s)


    and (Child’s full name)


    give consent for photographs/videos taken by RA Tas staff or media representatives during the Program.

    • I consent to photos/videos being taken as a record of the activity or the event; for evaluation reports; for publicity material on leaflets, websites, newsletters and social media; for illustrations of the activities or events in published articles; for grant applications and for media.

    • I understand that names and any other identifiable personal information will not be included on any material associated with photographs or videos without additional prior consent.

    • I understand that my child may be identifiable from the photograph or video, and consent to this use.


    Parent/guardian signature - please tick below to sign this document