DEBRA UK media consent form

We share media (including photos and videos) for many important reasons. It allows us to raise awareness of EB and feature people of all ages with all EB types in our marketing materials. Representing the whole EB community helps us to inspire others to become DEBRA members, and for others such as researchers and donors to support us. We share media in lots of ways – through our social media channels, in news articles, blogs, print publications, and on our website.

Please complete our form if you consent to share media you appear in.

Your details

Full name (required)

Date of Birth (required)

Address (required)

Postcode (required)

Phone number (required)

Email address (required)

Date (required)

Content

Will media featuring you and your family include any children under 16? (required)

If yes, please complete the section below.

Child’s name or names

Child’s DOB

I can confirm I am the legal parent or guardian of the child/children in this content and am able to consent to the use of this content.

Confirm

Please add your name here to confirm

Media consent from employer (where applicable)

Do we need to contact your employer’s communications team to approve the use of your content? (required)

NoYes

If yes, please provide their contact details

Content consent

Consent can be changed or withdrawn at any time by contacting DEBRA UK via email at [email protected] or by ringing 01344 771961. If consent is withdrawn, DEBRA UK will not use the media in any future publicity thereafter and all existing printed stocks (if applicable) will be destroyed.

I understand that that once media has been shared through social media channels, DEBRA cannot prevent it from being shared wider. (required)

Yes

I understand that my media may be used for the purposes listed above (list is not exhaustive) and will be added to DEBRA’s content bank for future use.  (required)

Yes

I understand that the details I provide and the media taken by or given to DEBRA UK will be used in accordance with all relevant and applicable laws (including, but not limited to, the General Data Protection Regulation). (required)

Yes

Thank you again for sharing your media with DEBRA UK. 

For more information on how DEBRA uses your information, please visit https://www.debra.org.uk/privacy-policy.

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