Chesterfield Tri Club Consent Form

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Email *

In accordance with our club policies we will not permit photographs, video or other images of any member to be taken without the consent of the individual or the parent (if the individual is under 16). Chesterfield Tri Club will take all steps to ensure these images are used solely for the purposes they are intended. If you become aware that these images are being used inappropriately you should inform Chesterfield Tri Club's Welfare Officer immediately.

Name *

Are you under 16? *

Yes

Required

To be completed by anybody 16 yrs and older

I give permission for my photograph to be used within the club for display purposes

I give permission for my photograph to be used within other printed publications

I give permission for my photograph to be used on the club's website

I give permission for videos of me to be used on the club's website

I give permission for my photograph to be used on the club's social media accounts

I give permission for videos of me to be used on the club's social media accounts

To be completed by parent/guardian if the individual is under 16

I give permission for my child's photograph to be used within the club for display purposes

I give permission for my child's photograph to be used within other printed publications

I give permission for my child's photograph to be used on the club's website

I give permission for videos of my child to be used on the club's website

I give permission for my child's photograph to be used on the club's social media accounts

I give permission for videos of my child to be used on the club's social media accounts

A copy of your responses will be emailed to the address you provided.

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