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Link Wentworth

13 14 21

02 4726 5500

Media Consent Form

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Media Consent Form
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Media Consent Form

Media Consent Form

Name(Required)
Name of parent or guardian (if applicable)
Email(Required)
I consent and agree that a representative of Link Wentworth Housing has permission to take photographs and/or video footage of me.(Required)
I consent and agree that Link Wentworth Housing has permission to use photographs of me or use my story in print materials for promotional, educational, reporting, training and/or commercial purposes. This includes materials such as annual reports, tenant handbooks, brochures, pamphlets and flyers to promote Link Wentworth and its services.(Required)
I consent and agree that Link Wentworth Housing has permission to use photographs and/or video footage of me and/or my story in digital form and/or online for promotional, educational, reporting, training and/or commercial purposes. This includes having my picture shared on Link Wentworth’s social media channels and website to promote Link Wentworth and its services.(Required)
I consent and agree that Link Wentworth Housing has the permission to share photographs/video footage of me or my story with external media and partners. (Please note: You will be notified if Link Wentworth plans on sharing your image with external media.)(Required)
I consent and agree that these photographs or video footage of me or my story can be used by Link Wentworth Housing for a period of up to five years. You can withdraw your consent by emailing communications@linkwentworth.org.au, calling 13 14 21 or posting your request to PO Box 5124 Chatswood West NSW 2067 and we will consider your request.(Required)
I understand that I will receive no payment for the use of the photographs and/or digital footage and/or interviews taken by Link Wentworth Housing.(Required)
I am over the age of 18 years old or a parent or guardian over the age of 18 years old has authorised on my behalf.(Required)
Clear Signature

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