RMHC-SEQ-MEDIA-CONSENT-FORM

RMHC SEQ Media Consent Form

Parent/Guardian Full Name(Required)

Email(Required)

Phone(Required)

Location(Required)

Room Number (if applicable)

Minor(s) Details

Minor Name(s)(Required)

Full Name

DOB

Terms and Conditions(Required)

I grant to (i) Ronald McDonald House Charities Pty Ltd, its local chapters and programs and its related bodies corporate, contractors, employees and agencies (together, RMHC) and (ii) all of RMHC’s corporate partners (together, the “Partners”), including but not limited to, McDonald’s Australia Limited, its related bodies corporate, contractors, employees and agencies and their respective agents and representatives (together “McDonald’s”, and together with RMHC and the Partners, the “Grantees”), the irrevocable and unrestricted right to publish, display and distribute materials bearing my name, voice, likeness or any other identifiable representation of myself (the “Material”), taken at the Event, for use in marketing materials in any medium (including print, online and video) and other publications. I release and hold harmless RMHC and the Grantees from any expectation of privacy, confidentiality or other rights I may have associated with the Material. I acknowledge that my participation is voluntary. I will not receive financial compensation of any type associated with the taking or publication of the Material or participation in RMHC marketing materials or other publications.I waive any rights in performance or similar rights that I may have in the Material and acknowledge and agree that I have no right of ownership or to royalties in the Material. I release RMHC, the Grantees and any third parties involved in the creation or publication of RMHC publications, from liability for any claims by me or any third party in connection with my participation. I have agreed to the above in consideration of the opportunity given to me by RMHC and the Grantees to appear in these Materials. I acknowledge that I have fully read and understand this document and that I have had any questions regarding its effect or the meaning of its terms answered to my satisfaction. I certify that I am at least 18 years of age, unless this document is also signed by my parent or legal guardian.