Declaration of Consent

I, the undersigned, have agreed to participate in this paid User Study with ______________________
(the “Company”) to provide a collection of original photographs containing my image (the
“Collection”). I agree to keep all information regarding this User Study and the Collection
confidential, and will not disclose the existence of, or any information about, the User Study or
Collection to any third person or party.

If the Collection is not photographed directly by Company or its representatives, the Collection will
be photographed directly by me in accordance with specifications provided by Company, and will be
photographed by me for the sole purpose of delivering the Collection to Company. I will not use the
Collection for any other purpose.

If the Collection is accepted by the Company as meeting the specifications, I will receive payment
from the Company for the Collection.

In consideration of my receipt of payment from the Company for the Collection, I hereby irrevocably
assign all right, title and interest, including any and all intellectual property rights, in and to the
Collection in accordance with the provisions set forth in Schedule 1, Third Party Consent Form,
attached to this Declaration of Consent.

I understand that Company is conducting this User Study on behalf of a third party, and that neither
Company nor I will retain any rights in or to the Collection.

I further understand that the Collection may be used to train, develop, improve, and maintain
artificial intelligence and machine learning products.

By signing this Declaration of Consent, I irrevocably consent to Company, its client, and the Third
Party Recipient referenced in Schedule 1, Third Party Consent collecting, using, transferring, and
processing my image, related personal and sensitive personal information, and the Collection for the
above purposes and as set forth in Schedule 1.

I have read and understand this Declaration of Consent and make this Declaration of Consent freely
and voluntarily.

Participant Name: .....................................................

Participant Signature: ...........................................................
Date: .............................................................
Email: .............................................................

The following must be completed if the Participant is less than 18 years of age:

I, the undersigned, am the legal guardian of the minor named above and consent to the participation
of the minor in this paid User Study with Company.

Guardian Name: .....................................................

Guardian Signature:...........................................................
Date: .............................................................
Schedule 1

Third Party Consent Form

[_____] I acknowledge that my personal data (including, but not limited to, video recordings, any
biometric data generated therefrom, demographic characteristics (e.g., age, gender), and any other
special categories of personal data or otherwise sensitive personal data (e.g., race, ethnic origin)) may
be processed by Company’s client and Company’s client’s ultimate client (the “Third Party Recipient”)
and may be used for the development, improvement, and maintenance of Third Party Recipient’s
commercial artificial intelligence and machine learning products and services, and may be further
published and shared in the manner described below.
If your personal data is provided to Third Party Recipient and Third Party Recipient’s processing of
your personal data is subject to data protection laws which require a lawful basis for processing, unless
your explicit consent is required, then Third Party Recipient’s processing of your personal data is
necessary for the performance of the agreement between you and Company.
[_____] I agree that Third Party Recipient may process biometric data from my video recordings to
develop, improve, and maintain Third Party Recipient’s commercial artificial intelligence and machine
learning products and services.
[_____] I agree that Third Party Recipient may process any other special categories of personal data
or sensitive data it collects about me (e.g., race, ethnic origin) to develop Third Party Recipient’s
commercial artificial intelligence and machine learning products and services. Where required by
applicable data protection laws, you may withdraw your consent for Third Party Recipient’s processing
of your personal data that is based on the lawful basis of consent at any time by contacting
_____________________________. Any withdrawal of consent will only take effect for future
processing after Third Party Recipient has received actual notice of your withdrawn consent and will
not affect the lawfulness of processing before Third Party Recipient received such notice.
[_____] I agree that my participation in this project is completely voluntary and that it is continuous
and binding on my personal representatives, heirs, and assigns. I agree that my participation in this
project does not grant me any rights in or to the data collected or processed, and does not grant me any
rights in or to Third Party Recipient’s products and services.
[_____] I agree that upon request I will promptly sign any additional consent form(s) requested to be
signed by the Third Party Recipient that are substantially consistent with the terms of this Third Party
Consent Form.

Participant Name:________________________
Participant Signature:_____________________
Date:__________________________________