Join Hands, Be Proud

1. Please upload your video below and complete the information requested to give consent for us to use your image, moving footage, audio, comments depicted in your video and other personal data to then be stored and used. The form below covers consent for use of the above for internal and external communication and storage of the data within this form. All data (images, film, comments, personal info on this form), will be stored by St.Helens Council. The data may be shared with 3rd party organisations in order to fulfil the communication work necessary, e.g. providing images to design/ print agencies.

Please read through the full privacy statement here https://www.sthelens.gov.uk/media/332808/idahot-2021-dp-privacy-1.pdf
*

File: {{filename}}delete

Choose File

2. Name of participant *

3. Address

4. Postcode

5. Telephone

6. Email *

7. Your Consent
I give consent to St.Helens Council to publish, republish, or otherwise transmit still and moving images
and audio I am featured in for the purposes of:

Publicity and promotional materials, including advertising material and printed publications
Presentation and exhibition materials
Websites, social media channels and digital communications materials, including advertising
material and printed publications
News media and their associated websites, social media channels, print publications,
television and radio

I understand the Council will keep all its images in accordance with data protection law and delete
the images that have not been used for any publicity or marketing after 2 years. I also understand that
the still / moving images / audio used for publicity or marketing purposes are in the public domain and
therefore could potentially be reproduced, altered, or re-used by anyone in the world outside of the
Council’s control. I know I have the right to withdraw consent at any time by emailing
mediateam@sthelens.gov.uk or by calling 01744 676164, but understand that withdrawing consent
may not affect the material that has already been used.

I am the person identified in the above section and in the filming and/ recording. I understand the above request and give informed consent

Under 16? I am the parent / guardian of the person identified in the above section and in the filming and/or recording and give informed consent for the person's image / data to be used.

8. Name of parent/guardian - if under 16

9. Contact Number of parent / guardian - if under 16

Powered by SmartSurvey