I give my consent to The Diocese of Hereford, its affiliates and agents, to use my image and likeness and/or any interview statements from me in all media known now or in the future. This consent includes, but is not limited to:
I confirm that I have read the information above and understand that I am able to withdraw my consent at any time, and will contact the Diocese of Hereford Communications Team to notify them of my withdrawal. If you are signing on behalf of the person (if subject is under 18 / as a legal guardian / carer / family member / responsible person) Please enter your own details in the Guarantor section. |