RESEARCH CONSENT FORM for St. Frances Cabrini host/ leader:
By my signature below, I agree to host a two-part digital storytelling retreat at St. Frances Cabrini church on March 9th and March 16th of 2024.
In agreeing to this hosting role, I understand the following:
1. That St. Frances agrees to provide an appropriate space for the retreat, to share publicity about the retreat in various communication forums, to offer any refreshments deemed appropriate during the retreat, and to collaborate with Dr. Hess to ensure that language appropriate to the context of St. Frances Cabrini is developed for the retreat.
2. That Dr. Mary E. Hess will lead a two-part retreat as part of her research exploring how people of faith view the earth and/or Creation in her role as a faculty member at Luther Seminary in educational leadership, and that there will be no fee involved for her leading the retreat.
3. That I will support Dr. Hess in developing a shared conversation agreement that is appropriate for our church and for use with participants, and that I will support the agreement during the retreat.
4. That I understand that participants will be bringing their own digital devices, photos, music, and any other media to the retreat and bear responsibility for ethical use (that is, not using photos they don’t have permission to use, and so on).
5. That I understand that any media created within the retreat will belong to the persons who created it, and I may ask that it be shared with our church but cannot compel such sharing.
6. That I am invited to remain in communication with Dr. Hess following the retreat for my reflections upon it, and that I may at any time contact Dr. Hess with any questions and concerns (651-641-3232).
7. That I can receive a copy of any research report generated as a result of this retreat.
Date:
(Signature of Dr. Hess)
Date:
Signature of leader hosting the retreat:
RESEARCH CONSENT FORM for workshop participants
By my signature below, I agree to participate in part one of a digital storytelling retreat at St. Frances Cabrini church on March 9th, 2024.
In agreeing to this participation, I understand the following:
1. That Dr. Mary E. Hess will be leading this retreat as part of her research exploring how people of faith view the earth and/or Creation in her role as a faculty member at Luther Seminary in educational leadership.
2. That Dr. Hess will protect my confidentiality and anything I create during this retreat unless I specifically give permission for her to make a digital story publicly available.
3. That I will participate in developing a shared conversation agreement with other participants, and will abide by the agreement during the retreat.
4. That I may at any point during the retreat cease to participate, and will be blessed and sent off with gratitude.
5. That I understand that I am bringing my own digital devices, photos, music, and any other media to the retreat and bear responsibility for ethical use (that is, not using photos I don’t have permission to use, and so on).
6. That I am invited to remain in communication with Dr. Hess following the retreat for my reflections upon it, and that I may at any time contact Dr. Hess with any questions and concerns (651-641-3232).
7. That I can receive a copy of any research report generated as a result of this retreat.
Date:
(Signature of Dr. Hess)
Date:
Signature of person participating in the retreat:
————————————————- for later use:
RESEARCH CONSENT FORM for digital story publication (if desired in part two of the retreat)
By my signature below, I agree to have my digital story made publicly available through Dr. Mary Hess’ website [earth.storyingfaith.org]
In agreeing to this participation, I understand the following:
1. That Dr. Mary E. Hess will be leading this retreat as part of her research exploring how people of faith view the earth and/or Creation in her role as a faculty member at Luther Seminary in educational leadership.
2. That I will abide by the covenant of presence agreement created during part one of this retreat.
3. That I may at any point during the retreat cease to participate, and will be blessed and sent off with gratitude.
4. That I understand that I am bringing my own digital devices, photos, music, and any other media to the retreat and bear responsibility for ethical use (that is, not using photos I don’t have permission to use, and so on).
5. That by signing this form I am giving permission to Dr. Mary E. Hess to post my digital story online so as to make it widely accessible.
6. That I retain the rights to post my video on my own (or any other site).
7. That there will be no fees assessed from me for this posting.
8. That following a series of digital storytelling workshops at diverse churches, these posted videos will form the substance of a second phase workshop in which people from diverse churches are invited to watch each other’s videos and then participate in a structured conversation with them.
9. That I am invited to remain in communication with Dr. Hess following the retreat for my reflections upon it, and that I may at any time contact Dr. Hess with any questions and concerns (651-641-3232).
10. That I can receive a copy of any research report generated as a result of this retreat.
Date:
(Signature of Dr. Hess)
Date:
Signature of person whose video is being posted:
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