Photography Consent Form

Public Relations Photography / Filming Consent Form

We often use photographs of people on our website and in publications to provide important information, publicise our services or record special events. We also make some short films for the same reason. These images may be sent to external media and published on the internet. We also work with external media on news stories or documentaries about our services. This form allows us to record that you have given informed consent for images of you or your child to be used in this way. Please be assured that this is completely your decision and we totally understand if you would prefer not to be filmed or photographed. Your decision will never affect your care or that of your loved one or friend.

Your name(Required)

First Last

Name of child* (if applicable)

First Last

*You must be a parent/carer with the legal right to consent on their behalf.

Relationship to child (if applicable)

Email(Required)

Phone

Date

Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Reason for photography / filming:(Required)

Location of photography / filming:(Required)

Name of member of staff conducting photography / filming:(Required)

Any restrictions on use?

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