Media Consent Form

UnitingCare Wesley Bowden (UCWB) uses promotional and educational materials that can be used in print materials or online such as the UCWB website.

UCWB seeks permission to use the following:

  • Media (photograph, audio, film recording) in which you appear;
  • A written comment by you; and/or
  • Art or other work samples created by you in a UCWB course / event / workshop.
  • By completing, signing and returning this form you are granting UCWB permission to use:
  • An image or recording of you which appears in a photo, film and / or audio recording to publish on paper and / or on websites
  • Your work samples on paper and / or on websites;
  • An image or recording of you which may identify you by first name and/or organisation, or the service you are receiving only; and/or
  • Work samples created by you without identifying you, or by identifying you by first name and / or organisation, or the service you are receiving only.

Although you have provided your consent, we might not use the item.
Media, comments and / or work samples might not appear in exactly the same form in which they have been submitted.

Your permission will remain valid until notification to the contrary has been received in writing by UCWB.

By signing this Form you acknowledge that there shall be no claim on your behalf for any monetary compensation in the use of such material now or in the future.