COMMUNITY HUB PHOTO, VIDEO and MEDIA CONSENT FORM

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Purpose of this Form
Streams of Living Water Inc. and partner organisations/providers may take photographs or video recordings during activities, workshops, events, and programs held within our SOLW Goodall Community Hub.

These photos and videos may be used to celebrate participation, promote activities, share community stories, and raise awareness of programs and services.

Images and recordings may be used in:
• Social media platforms (Facebook, Instagram, etc.)
• Websites
• Newsletters
• Promotional materials and brochures
• Community reports and presentations
• Printed publications and marketing materials

Participation in activities is not affected if you choose not to provide consent.
If, after signing this form, you decide you no longer wish to give permission, you may withdraw your consent at any time by contacting the Coordinators at Streams of Living Water Inc (Rhorie and Joy) events@solw.org.au

Withdrawal of consent will apply to future use where possible, however material already published may not always be able to be removed.

PART A: Participant Information

Name

First Last

Phone

Date

Parent/Guardian Name (if applicable):

PART C: Additional Notes or Restrictions
Please advise us of any preferences or restrictions regarding photographs or videos (for example: group photos only, no close-up photos, no names published, etc.)

Please advise us of any preferences or restrictions regarding photographs or videos (for example: group photos only, no close-up photos, no names published, etc.)

PART D: Declaration and Signature

By signing this form, I confirm that:

I understand the purpose of this consent form.

I understand participation in activities is not dependent on giving photo or video consent.

I understand that I may withdraw my consent at any time by contacting Streams of Living Water Inc.

I understand that every reasonable effort will be made to respect my privacy and preferences.

I understand that photographs and videos already published before consent is withdrawn may not always be able to be removed.

Participant Name:

Participant Signature:

Date

Parent/Guardian/Carer Name (if applicable):

Parent/Guardian/Carer Signature:

Date

HOMECARE

ACCOMMODATION

COMMUNITY SUPPORT

COMMUNITY HUB PHOTO, VIDEO and MEDIA CONSENT FORM