Media Consent Form

Phone

This field is for validation purposes and should be left unchanged.

Media Consent:

OVER 18 – Media Consent:

I hereby give my permission for the unlimited use of

• video and/or photographs containing my physical likeness; and/or
• my voice and other sound effects I may produce.

for any purpose including, but not limited to, social media posts, publications, promotions both online and in print. I waive any rights, claims or interest I may have to control the use of my identity or likeness in this media and agree that any uses henceforth may be made without consultation or compensation. I give express permission for this media to be optimised, cropped or edited as required. I acknowledge that the footage or photograph/s can be used for an unlimited period of time in Australia. I understand there will be no fee involved in this production.

I certify that I am over 18 years of age:

Full Name(Required)

First Last

Name of signatory(Required)

Date(Required)

UNDER 18 – Parent / Guardian Consent:

I hereby give my permission for the unlimited use of

• video and/or photographs containing my physical likeness; and/or
• my voice and other sound effects I may produce.

I hereby grant permission the use of photographic and/or filmed images of this child, and/or their voice, as outlined above.

Child's name(Required)

Child's age(Required)

Please enter a number from 0 to 21.

Requirements(Required)

You can identify this child by their full name as written above.

Please identify this child by first name ONLY.

Please do not identify this child by name.

I certify that I am over 18 years of age and I am the parent / guardian of the child named above.

Full Name(Required)

First Last

Name of signatory(Required)

Date(Required)