City of Canterbury Bankstown Photography/Audio/Videography Consent Form

Event Details

Event Date *

Event/Project Name

Participant Details

Full Name of participant *

Date of Birth

Only add another participant if children in a group are under 18 and have the same parent or guardian.

Is the participant over the age of 18? *

YesNo

Consent

I acknowledge that in giving my consent:

I (Participant or parent/legal guardian of Participant) hereby give Canterbury-Bankstown Council (Council) the right to make, use and/or retain any photograph, audio and/or video of the Participantfor promotional and commercial purposes.

I understand that:

Council will not pay me for giving this consent;
Council’s obligations regarding privacy and collection of personal information can be viewedonline via www.cbcity.nsw.gov.au/council/privacy-statement;
I may withdraw my consent only by giving Canterbury-Bankstown Council notice in writing to:
Attention: Communications Unit, Canterbury-Bankstown Council,PO Box 8, Bankstown NSW 1885 or council@cbcity.nsw.gov.au;
Council may keep the photographs, audio and/or video/s on record unless and until I withdrawmy consent;
Council will at its absolute discretion return or destroy the photographs, audio and/or video/sif I withdraw this consent, except of those already distributed, published or broadcast.

I certify and represent that I:
(a) have read the terms and conditions contained in the link and fully understand their meaning and effect; and
(b) agree to and accept the terms and conditions. *

Parent/Legal Guardian Details

Full name of parent/legal guardian of participant *

Which contact details can you provide? *

EmailPhonePrefer none

Email address *

Contact number *

Your address

Street address

City

State

Postcode

I declare that I am the parent/legal guardian of the following child or children or holder of authorised substituted decision-making responsibility for the following person/s (collectively “the subjects") *

Please sign below *

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Date

For photographers use only

Photo of participant

Browse

This is to help us identify the participant in photos/videos.

Image #

Image description