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Hidden Disabilities Sunflower ('HDS') Model release form

Media consent form

Please read and complete the following form and then click on SUBMIT. Please get in touch if  you have any other queries, or wish to speak to someone at  Hidden Disabilities Sunflower before completing the form, please email Hidden Disabilities Sunflower Marketing.

  1. I give my permission to you, Hidden Disabilities Sunflower ("HDS"), to use my stories, quotes, and photographs/video film/audio. I hereby grant HDS the absolute right to use the stories, quotes, audio and images resulting from the interviews and photography/video shoots, and any reproductions or adaptations of the images for any purposes in relation to HDS’s work including, without limitation, the right to use them in any advertisements and other publicity materials, direct mail, books, newspapers, magazine articles, television programmes and internet publications to promote and raise awareness of HDS and the Sunflower.
  2. I understand that HDS will keep all the images and story content and use them for an indefinite period, but that I can withdraw my consent in writing at any time – this can be done by emailing Hidden Disabilities Sunflower Marketing
  3. In the event of Content created by HDS (in a photo shoot or during filming), I understand that I do not own copyright or have any rights of ownership or other claim over the Content. I understand that Content for which I retain ownership is not subject to any form of compensation by HDS for its use, unless otherwise agreed.
  4. In the event of content created by myself, I understand that I keep ownership of the copyright or the rights of ownership over the content
  5. I understand that the content may be identified with my name, and that text may indicate that I live with a particular condition in order to promote HDS’s work.I can choose to remain anonymous in the form below. I will not make any privacy violation claims in relation to any uses of the Content within the scope of this consent.
  6. I understand that HDS will keep all the Content and use it for such period as it considers appropriate, unless agreed separately on the form below

Who can give consent?

The Content creator must give consent. In addition, if the Content includes an individual (“Model”) or multiple models, all Models must give consent:

  • 18 years old and older, who understand the consent process, can sign for themselves 
  • parent/guardian of someone who is under 18 or by a person with authority to sign for someone who cannot sign for themselves

Name as you would like it to appear alongside the content

REGION

Witnessing Consent

This section must be completed by the parent/guardian of someone who is under 18 or by a person with authority to sign for someone who cannot sign for themselves.