DD/MM/YYYY

• In printed marketing materials (e.g. a leaflet to promote Humanity First)
• On the Humanity First website or social media sites
• In the media (e.g. to promote the charity in a newspaper or on TV)
• In our printed or online advertising
• By other organisations that want to promote the charity’s work (e.g. schools, colleges, funding bodies and private sector organisations)

It will be used until you ask us to stop using it.

Please tick to give your consent

	I understand my right to ask to see any information held about me by Humanity First.
	I also understand that while Humanity First makes every effort to ensure all media coverage is positive, the Charity does not have final control over how a journalist may portray me.
	Humanity First will only pass your information on to third parties with your consent or where we are required to do so by law. You can write to us if you would like to see any information which we hold about you. We will provide this information in line with the Data Protection Act.

Details of person giving consent:

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If you are under 16, consent is required from a parent or guardian:

Parent/guardian name: