Student Media Consent & Release Form

Student Media Consent & Release Form

Academy of Workplace Learning RTO #40603 | V.1 September 2024 | AOWL-025
PURPOSE

This form requests consent for students to be photographed, recorded and/or featured in media produced by or for the Academy of Workplace Learning for educational, promotional, and archival purposes and compliance with NSW and Australian training requirements.
STUDENT INFORMATION

First NameLast Name
Email
example@example.com
Mobile Number
Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
USI
Address of Releasor

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
CHC33021 Certificate III Individual SupportCHC43015 Certificate IV in Ageing SupportCHC43121 Certificate IV in Disability SupportCHC43315 Certificate IV in Mental HealthCHC30121 Certificate III in Early Childhood Education and CareCHC50121 Diploma of Early Childhood Education and CareHLTAID011 Provide First AidHLTAID009 Provide cardiopulmonary resuscitationOther

DECLARATION
I give Academy of Workplace Learning my permission to use any photographs, videos, audio recordings and/or survey testimonials taken of myself throughout my course of training for the sole purpose of promoting Academy of Workplace Learning as a training organisation.

I understand that any photographs, videos, audio recordings and/or survey testimonials taken of myself throughout my course of training with Academy of Workplace College may be used in any form deemed appropriate by Academy of Workplace Learning including but not limited to, electronic and printed publications such as training flyers, newsletters, magazines, display boards, Academy of Workplace Learning website and/or any other electronic forms of media, at the discretion of Academy of Workplace Learning College without further notice.

The material may be published, broadcast or communicated by us or others with our permission, in any media including but not limited to the internet, websites, social media channels or other multimedia and in any publication, calendar, catalogue, brochure or report.

I hereby release my claim to all demands, proceedings, costs and/or expenses that may arise out of the use of this promotional material and I understand that Academy of Workplace Learning will be solely responsible for all outcomes in relation to the use of this promotional material.

I have read, I understand, and I accept the responsibilities and obligations for this arrangement, and I declare that the information I have provided is true and correct, to the best of my knowledge.

To be able to sign this agreement you must be over 18 years of age. If you are under 18, your parent or guardian will need to sign this agreement where indicated below.

I have read this release and I understand what it means. I am over 18 years of age.
Signature
Date

MonthDayYear
Date
NOTE: For learners under the age of 18, a parent or legal guardian must print their name and sign this form below.
I am the parent or legal guardian of the named minor in this agreement. I have read this release before signing below, and I fully understand the contents, terms, and the effect of this release.
Full name of parent or legal guardian

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Signature of Releasor or Releasor's Guardian
Date

MonthDayYear
Date
Should be Empty:

Student Media Consent & Release Form

PURPOSE

DECLARATION