Media Release Form

The purpose of this form is for your to provide consent to The Healthy Mummy to use your image(s) and words in their marketing and promotions.

Please note you may refuse to provide consent and/or contact us at any stage to ask we cease using your image(s) and words.

Conditions of Consent

1. THM will own any and all rights in the photography, recording or filming.
2. I hereby provide consent for The Healthy Mummy (THM) and/or its representatives, agents and related entities to Use any photographs, film, videos, audio recordings of my Appearance for promotional, commercial, and marketing purposes, wether or not it is accompanied by any narration or dialogue, by any present or future media or means known or unknown.
3. I consent to the use of any printed material in conjunction with the above-mentioned Use.
4. I hereby waive all personal rights and objections to, including the right to inspect, any Use which will be made of my Appearance by THM.
5. I understand that I will not receive any further compensation or payment or any form of remuneration now in the future in consideration for the above consent, outside of which has been agreed to with THM.
6. I acknowledge that images of my Appearance may be transferred outside of the United Kingdom and store and processed overseas.
7. I agree that THM may use my photographs/film/words without my name and for any lawful purpose including for example such purposes as publicity, illustration, advertising, social media and Web content.
8. Definitions:
   1. Appearance means my name, image, physical likeness, voice, any and all attributes of my personality and/or performance;
   2. THM means The Healthy Mummy, and any successors, assigns, or licensees;
   3. Use means the lawful use and includes the exclusive and perpetual right of THM in any jurisdiction worldwide to:
      1. use, copy adapt and/or exploit;
      2. mix, edit, duplicate, or re-use, or creative derivative works;
      3. assign, licence or sub-licence;
      4. publicise and/or market; and
      5. exhibit and/or perform and/or distribute by any present or future media, for profit or otherwise.

Fill in your details here

To provide your consent please fill in your details below.