Photography / Videography Consent Form

1
Which event or occasion is image/video consent being given for?* This field is required.
2
Date of the event* This field is required.
Date
Year
Month
Day
3
Who are you filling out this form for?* This field is required.You must be over 16 to fill the form out yourself
For myself
As a Parent or Guardian
4
Your Full Name* This field is required.
First Name
Last Name
5
Email Address* This field is required.This information will only be used to contact you should there be any queries or issues relating to the images/videos taken at the event. This information will never be shared with anyone else.
example@example.com
6
Full Name of your Child* This field is required.
First Name
Last Name
7
Name of Parent / Guardian (Your Name)* This field is required.
First Name
Last Name
8
Age of Child* This field is required.
9
Email Address* This field is required.This information will only be used to contact you should there be any queries or issues relating to the images/videos taken at the event. This information will never be shared with anyone else.
example@example.com
10
Declaration - Personal Consent Submission* This field is required.I give my consent to the Diocese of Manchester as part of the Church of England, including its affiliates and agents, to use my image and likeness and/or any interview statements from me in all media known now or in the future. This consent includes, but is not limited to: Permission to interview, film, photograph, tape, or otherwise make a video reproduction of me and/or record my voice; Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of me, and/or recording of my voice, in part or in whole, in its publications, in newspapers, magazines and other print media, on the internet, television, radio and electronic media, in theatrical media and/or in printed materials such as booklets, reports and leaflets. I confirm that I have read the information above and understand that I am able to withdraw my consent at any time, and will contact the parish or Diocese of Manchester’s Communications Team (comms@manchester.anglican.org) to notify them of my withdrawal. Do you accept the declaration of use outlined above?*
Yes
No (please follow our next steps)
11
Declaration - Consent for Child* This field is required.I give my consent to the Diocese of Manchester as part of the Church of England, including its affiliates and agents, to use my child’s image and likeness and/or any interview statements from them in all media known now or in the future. This consent includes, but is not limited to: Permission to interview, film, photograph, tape, or otherwise make a reproduction of my child and/or record their voice; Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of my child, and/or recording of their voice, in part or in whole, in its publications, in newspapers, magazines and other print media, on the internet, television, radio and electronic media (social media / websites), in theatrical media and/or in printed materials such as booklets, reports and leaflets. I confirm that I have read the information above and understand that I am able to withdraw my consent at any time, and will contact the parish or Diocese of Manchester’s Communications Team (comms@manchester.anglican.org) to notify them of my withdrawal.
Yes
No (please follow our next steps)
12
I do not wish to give consent for myself / my child to be photographed or filmed.* This field is required.We respect your right to refuse consent for the usage of imagery and video featuring yourself, or your child. Although we aim to use our content to enrich our communications and materials, we understand that in some cases, people would prefer not to be featured. We advise you to let the photographer or videographer know that you do not wish to be filmed or photographed on the day. For some events, there will be allocated areas or stickers handed out to help identify that you do not wish to be captured. If you wish to amend your decision, please select the option below. You have a right to withdraw consent at any point you desire. If you wish to withdraw consent, or have content removed featuring you or your child, please contact comms@manchester.anglican.org. We also have a content removal form available that will allow you to identify the content you wish to remove.
I do not wish to give consent for myself / my child to be photographed or filmed
13
*OPTIONAL* Photo SubmissionWe do our best to ensure that those who do not wish to be photographed or filmed are respectfully and creatively removed from any media we capture. For larger events, it can be helpful to have a simple image of yourself or your child, so we can know who not to capture. This is entirely optional, and is only used by the data handler when sorting through the imagery or video captured, to ensure that content is deleted. Any imagery held here is held purely for the purpose of identification and will be deleted immediately after the data has been sorted - typically within 24-48 hours of the event.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Please provide a simple headshot image of yourself or your child for identification purposes when editing. This is entirely optional.
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