Consent Form

Scott's Goodie Bag Redemption Consent Form
Dear Parents,

We understand that your child’s health is of utmost importance. Understanding nutrition and instilling good eating habits in our children is vital for their overall health and wellbeing, setting them up for the long run.

In collaboration with participating school, [] and Scott’s Malaysia, we present to you the Little Nutritionist Workshop Program, an initiative to promote healthy eating habits and the importance of the various vitamins and minerals in our daily nutritional requirements.

The program entails an engaging edutainment session covering the essential nutrients which our body requires and nutrients that can be derived from the various food groups. At the end of the session, a goodie bag containing samples of Scott’s Products (Scott’s Pastilles/Scott’s Gummies/Scott’s Emulsion) will be distributed to the participants.

We would require your consent in order for your child to receive the goodie bag. By giving your permission in this form, you agree to Haleon’s Terms and Conditions and consent to your child receiving the goodie bag.

Please be assured that collection of your child's data in this form will only be for the purposes of distributing the goodie bags. Your child’s information will not be stored post-conclusion of the programme. If you have any questions about the programme and samples included in the goodie bag, please contact Motherhood Marketing Team from Motherhood via email at

Thank you.


Motherhood Team

Please sign this consent form below

Form Questions

1. Name of Parent/ Guardian*

2. Relationship with Child/ Children*

3. The goodie bag will consist of Scott’s Multivitamin Gummies, Scott’s Vitamin C Pastilles, Stickers, and Activity Book. After reading this, do you give your permission to accept Scott’s Goodie Bag*

4. Name of your Child/Children*

5. Please select your child’s / children school:*

6. Your Child’s/Children’s’ Class*

I confirm that:-
Terms & Conditions:

Haleon respects your privacy. When you fill up this form, Haleon and/or its respective authorised agents may collect, process, use, store, disclose and/or transfer any of your personal data provided for purposes set out in this form. Where you have opted in to receive products information and marketing materials and relevant communications mentioned below, Haleon and/or its authorised agents may use your personal data for this purpose.

Please review Haleon’s Privacy Notice to read more about how we use your personal information and your rights in relation to that information. You may withdraw your consent at any time or otherwise request to exercise your rights in relation to your personal data as advised in the Haleon's Privacy Notice.