The Media Consent Form Template – Australia is offered in multiple formats, including PDF, Word, and Google Docs. These formats are conveniently editable and printable, ensuring they cater to your specific requirements effortlessly.
Media Consent Form Template – Australia Editable | PrintableSample
1. Participant Information 2. Purpose of Media Consent 3. Media Types Covered 4. Usage of Media 5. Duration of Consent 6. Revocation of Consent 7. Acknowledgment of Information 8. Contact Information for Queries 9. Signatures and Confirmation
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Examples
[Full Name]
[Address]
[Phone Number]
[Email Address]
[Organization Name]
[Organization Address]
This Media Consent Form enables [Organization Name] to capture and use media, including photographs, audio recordings, and video footage, for promotional purposes including, but not limited to, advertising, social media, newsletters, and website content.
– Photographs
– Video recordings
– Audio recordings
– Digital content
I, the undersigned, hereby give [Organization Name] permission to use my likeness in media for the purposes described above. I understand that this may include widely disseminated materials.
This consent is granted for an indefinite period, unless revoked in writing. I understand that I can withdraw my consent at any time by contacting [Organization Contact Information].
I acknowledge that I will not receive any compensation for the use of my likeness in media. I understand that my participation is voluntary and that I may decline to participate.
I release [Organization Name], its representatives, and employees from any and all claims, demands, and liabilities arising from or related to the use of media as outlined above.
This Consent Form shall be governed by the laws of Australia.
[Signature]
[Printed Name]
[Full Name]
[Address]
[Contact Number]
[Email Address]
[Organization Name]
[Address of Organization]
This form is intended to grant [Organization Name] the rights to capture and showcase my image and voice for promotional initiatives including advertisements, digital media, and press materials.
– Images (photos)
– Video clips
– Audiovisual content
I hereby grant [Organization Name] the permission to create and use the media as described, with the understanding that it will be used solely for the outlined purposes.
This permission is effective from the date of signing and remains valid until revoked in writing. I am aware that I can withdraw my consent by notifying [Organization Contact Details].
I acknowledge that this authorization is given without any expectation of financial rewards or compensation now or in the future.
I discharge [Organization Name] from any liability related to the use of the media as indicated in this form.
This Compliance Form shall be governed under the laws of Australia.
[Signature]
[Printed Full Name]
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