Gallery Consent | Tongue-tie Practitioners

GALLERY CONSENT FOR IMAGES

Photographic consent is required when you submit this form. Please ensure it includes the date, & the printed name with the signature of the legal caregiver who holds parental rights.

Thank You

Gallery Consent Form

I/We

The parents / legal guardians of

Your Email address:

Hereby give the Association of Tongue-tie Practitioners ( ATP) permission to use any still and/or moving image(s) being video footage, photographs and/or frames and/or audio footage depicting my/our child named above on

The ATP may use our child’s image on the following Association of Tongue-tie Practitioners materials: 1) Website www.tongue-tie.org.uk 2) Leaflets/ Adverts/ Marketing 3) Training & educational packages The above consents will apply throughout the world and be for an indefinite period

Please upload a photograph of your signature(s), Printed name in capital letters and the date. This will need to be in Black ink and on white paper

**SIGNATURE** Consent

Photo Upload 1

Upload PHOTO

Photo Upload 2

Upload PHOTO

New Field:

I have read and agree to the Privacy & Cookies Policy (Link below this form in the footer)

Thank you for contacting us.

Please bear with us whilst we process your application. The ATP committee all work as volunteers alongside managing their own working lives and families. We will do our very best to ensure that this service is as swift as it can be.

Gallery Consent Form

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