Please return this completed form to
BROOKSIDE PRIMARY SCHOOL Using images of children Consent form for use by Cheshire West and Chester Council schools.
Often, we take photographs and videos of the children at our school. We use these images in our school displays, newsletter, prospectus or in other printed publications that we produce, as well as on our website, class blog, and facebook pages. From time to time, our school may be visited by the media who will take photographs or film footage of high profile events. Pupils will often appear in these images, which may then appear in local or national newspapers, or on televised news programmes. Each year group has its own page on our website, the purpose of which is to share learning. Photos and videos may be uploaded onto these sites and children are encouraged to take part in discussion forums as part of their homework. The children are very enthusiastic and will love to see their photos/work on display. No surnames are used with a photograph published externally in the media without separate consent. All entries are approved before they are published on-line. Before we take a photograph, we need written consent in order to comply with the Data Protection Act 1998. Please answer the following questions, then sign and date the form. If the form is not signed, we cannot, and will not use the photograph/video. Therefore, your child will not be allowed to take part in photographs/videos of their class
Name of child: ……………………………………………………………………… Class ……………………….. Name of parent/carer: ………………………………………………………………………
Please circle one answer May we use your child’s photograph within class/school in displays
Yes/ No
May we use your child’s photograph in the school newsletter, prospectus and other printed publications that we produce for promotional purposes?
Yes/ No
May we use the child’s image on our Website, Class Blog, Facebook,
Yes/ No
May we record your child’s image on video or webcam? (No surnames used)
Yes/ No
Are you happy for your child to appear in the media?* (No surnames used)
Yes/ No
*Please note that websites can be viewed throughout the world and not just in the United Kingdom where UK law applies. Name of authorising adult (block capitals please) ________________________________________________ Signature of authorising adult___________________________________________Date__________________