Model Release Form

  • At Interserve we like to share the good work we do with the people who are likely to use and benefit from our services and the organisations who partner with us to manage change.

    In order to share our good news with these audiences we often create content and photography for marketing and public relations purposes. Content and photography is published on or websites or distributed as press releases to local and national press and other media. Content might also be used for advertising promotion, marketing and packaging.

    We are delighted you have agreed to feature in our publicity materials. However, we need your written permission to proceed. Please complete the form below.

    I hereby give permission for my photograph / video / quotations to be used solely for the purpose of publicising the work of Interserve. I understand my photograph / video / quotations may be used to promote the work of Interserve in the following communication channels: websites and social media; staff magazines and intranets; Interserve marketing and promotional materials; local and national media.

  • Date Format: DD slash MM slash YYYY
  • To be completed by parent or legal guardian (for minors under 18)

  • Date Format: DD slash MM slash YYYY