--- title: Media consent for a minor description: A parent or guardian chooses where photos and video of their child may be used, with safeguards and a clear way to withdraw. --- # Media consent for a minor A parent or guardian chooses where photos and video of their child may be used, with safeguards and a clear way to withdraw. ## Who signs - Parent or guardian ## Fields - Parent or guardian: Organisation (text) - Parent or guardian: Event or activity (text) - Parent or guardian: Child’s full name (text) - Parent or guardian: Child’s date of birth (text) - Parent or guardian: Inside the Organisation, such as displays, newsletters and noticeboards (checkbox) - Parent or guardian: On the Organisation’s website (checkbox) - Parent or guardian: On the Organisation’s social media accounts (checkbox) - Parent or guardian: In news stories and press releases (checkbox) - Parent or guardian: In training or teaching material (checkbox) - Parent or guardian: Write “first name allowed” if it may (text, optional) - Parent or guardian: Organisation’s email (text) - Parent or guardian: An earlier end date, if I want one (text, optional) - Parent or guardian: Your full name (text) - Parent or guardian: Your relationship to the child (choice) - Parent or guardian: Your phone (text) - Parent or guardian: Your email (text) - Parent or guardian: Printed name (text) - Parent or guardian: Parent or guardian signature (signature) - Parent or guardian: Parent or guardian date signed (date signed) ## The document Media Consent for a Minor Permission from a parent or legal guardian ____ (Organisation) (the “Organisation”) would like to take photographs and video of children at ____ (Event or activity) and to use some of them. We ask for your permission, and for your choices, before we do. You can say no to any or all of the uses below, and saying no will never affect your child’s place or treatment. Section 1: The child 1.1 Child’s full name: ____ (Child’s full name) 1.2 Child’s date of birth: ____ (Child’s date of birth) 1.3 I am this child’s parent or legal guardian and I am entitled to give this consent. Section 2: Where pictures of my child may be used 2.1 Tick every place you agree to. Anywhere you do not tick, the Organisation will not use pictures of your child. ____ (Inside the Organisation, such as displays, newsletters and noticeboards) Inside the Organisation, such as displays, newsletters and noticeboards ____ (On the Organisation’s website) On the Organisation’s website ____ (On the Organisation’s social media accounts) On the Organisation’s social media accounts ____ (In news stories and press releases) In news stories and press releases ____ (In training or teaching material) In training or teaching material Section 3: My child’s name 3.1 The Organisation will not publish my child’s full name alongside a picture of them. If I agree to a first name only, I have written “first name allowed” here: ____ (Write “first name allowed” if it may) Section 4: Keeping children safe 4.1 The Organisation will not publish information that would allow a stranger to find my child, such as a home address, school, or the times and places where my child can be found alone. 4.2 Pictures are taken only by people the Organisation has approved and checked, using the Organisation’s own equipment or, where a personal device is used, only with the Organisation’s permission and with the pictures moved to the Organisation’s systems and deleted from the device as soon as possible. 4.3 If my child tells the photographer, or an adult, that they do not want to be photographed, the Organisation will respect that, whatever I have ticked. Section 5: How the Organisation will look after the pictures 5.1 The Organisation will take pictures only of children who are suitably dressed and taking part in the activity, will not take pictures in changing areas or toilets, and will choose pictures that show children in a positive way. 5.2 Pictures will be stored securely, kept only for as long as they are needed for the purposes above, and then deleted. Only the Organisation’s own staff and volunteers who need them will have access. 5.3 Pictures posted online can be seen by anyone, copied and shared, and the Organisation cannot control what others do with them once they are public. I have thought about this in making my choices. Section 6: Changing my mind 6.1 I may withdraw this consent at any time by writing to the Organisation at ____ (Organisation’s email). The Organisation will stop using the pictures and take them down from the places it controls within thirty days, and will tell me when it has done so. It cannot recall printed material already given out. 6.2 This consent lasts until my child leaves the Organisation, unless I withdraw it sooner, or until ____ (An earlier end date, if I want one). Section 7: My details 7.1 My name: ____ (Your full name). My relationship to the child: ____ (Your relationship to the child). 7.2 My phone: ____ (Your phone), and email: ____ (Your email). Signatures I have read this form and I understand my choices. I give consent as ticked above. Parent or guardian ____ (Printed name) Printed name ____ (Parent or guardian signature) Signature ____ (Parent or guardian date signed) Date ## Use it Sign up free and this template opens in your workspace with the fields already placed: /signup?starter=media-consent-minors A starting point in plain words, not legal advice. Change anything that does not fit before you send it.