Media consent form

Title

Date of birth

First name

Last name

Do you consent to The Brain Tumour Charity using your likeness in its marketing and PR activities (social media, website, literature and print, etc)?

YesNo

In the face of 72% of childhood brain tumours being cancerous, it is especially important for under 16s to feature in our materials so that other children do not feel alone. By giving us permission to use images, containing likeliness of you, your child/children or someone you care for, you will be helping us to raise awareness and inspire others.

I would also like to consent to The Brain Tumour Charity using images containing the likeness of my family members including photographs of my children and family in its marketing and PR activities (social media, website, literature and print, etc) ?

YesNo

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