MEDIA CONSENT & RELEASE FORM

Purpose: This release form allows Cattarin Cohort to record, use, and distribute media featuring the below participant & associated business (where applicable) and content for educational, promotional and informational purposes.

Consent to Collect Personal Information: By filling out this form, you consent to Cattarin Cohort collecting and processing your personal information (including your name, contact details, and any other information provided in this form) for the purposes of recording, using, and distributing media as outlined in this agreement. Your personal information will be managed in accordance with the Australian Privacy Principles (Privacy Act 1988) and international regulations such as GDPR, where applicable.

I consent to the collection and processing of my personal information as described above.

Participant Information:

First name*

Last name*

Preferred Pronouns

She/Her/Hers

He/Him/His

They/Them/Theirs

Custom

Business name (if applicable)

Position/Title

Email*

Yes, subscribe me to your newsletter.

Phone Number (for logistical contact)

Additional Details:

Site Details: Site details, address, contact, access instructions
Background Media Subjects: If there are background media subjects (staff/confidential or sensitive material matters) that you do not wish to appear in media content please list them here

Accommodations:

We aim to create an inclusive and comfortable environment for all participants. Please indicate any accommodations you require during the media recording process. We will do our best to provide these accommodations based on available resources.

Accommodations:

Visual Sensory Adjustments: Lower/no lighting panels

Pre-Session Questions: Advance questions, clarification opportunities

Physical Accessibility Needs

Auditory Sensitivity: Use of headphones/earplugs, noise management

Sensory Adjustments: Minimise background noise, reduce lighting

Breaks: Timing of breaks for longer sessions

Communication Preferences: Email/text-based options

Reduced Standing Tolerance: Seated preference for filming/photography

Other/Additional Details:

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Cohort Commendation's

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