Media Consent Form

Facial Palsy UK would like to use your/your child’s photographs/video in press releases, on the Facial Palsy UK website and/or for educational and promotional uses which may include use on social media.
To comply with the General Data Protection Regulation (GDPR), we need your permission to use photographs of you or your child. Please answer the questions below then tick the checkbox to give your consent. We will not use the images taken, or any other information you provide, for any other purpose, without your express consent.
Subject's Name(Required)
Parent/Guardian Name (if applicable)
Address(Required)
Email(Required)

Conditions of Use

By ticking the checkboxes below you agree:

1. that Facial Palsy UK may use the images and/or videos in which you and/or your child appear, and reference to your/their name where necessary, in presentations, on our website, in publications (such as leaflets, posters, newsletters and other marketing materials), and on our social media channels including Facebook, Instagram, Twitter, TikTok and LinkedIn.

2. your image and/or videos may be sent onto third parties for the purpose of media and other opportunities.

3. that the images and/or videos may be stored by Facial Palsy UK on their computer system, which may include storage in a virtual cloud.

4. that if you no longer wish us to use your stories, photographs and videos, you will notify us that you wish to withdraw consent by filling in our Withdraw Consent Form or by emailing info@facialpalsy.org.uk. Facial Palsy UK will do our best to ensure that the material is deleted so far as in our control.

5. that the material may be edited at the discretion of Facial Palsy UK.

Consent

Please read our Privacy Policy and/or our Children's Privacy Policy (for children aged 13 and over who you might be signing for) before giving your consent to make sure that you understand your rights about your personal data.

I give Facial Palsy UK permission to use my images/videos as outlined in the conditions of use above.(Required)
I give my permission for my images/videos to be sent to third parties for the purpose of media or other opportunities.(Required)
I give my permission to include my images/videos on social media such as Facebook, Twitter, LinkedIn, Instagram and TikTok.(Required)
If signing on behalf of a child, I confirm that I have discussed with them where possible and confirmed they are happy to have their image used in this way.(Required)
Would you like to receive Facial Palsy UK’s email newsletter?(Required)

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