IMAGE CONSENT FORM
The trainings of RCN Justice and Democracy address several themes concerning recent mass violence here and elsewhere in the world: - the consequences of these crimes - mechanisms that could lead to polarisation and exclusion in society - stimulating participants to (re)build a critical, active and committed citizenship See www.rcn-ong.be for more information. In order to improve our external communication, we would like to film and photograph our activities. In this regard, we would like to ask for your permission to take your picture and use this for our external communication. Thank you in advance for your collaboration. Wasja Rijs Education officer – Belgian program
I, signatory ……………………………………………………………………………………………………………………, hereby declare that I grand RCN Justice & Democracy permission and give my consent to use images or electronic media (taken on the day of the event) free of charge for presentation under any legal use. On these images I am recognisable). These images will be used to promote the activities of RCN Justice & Democracy with their target audiences via brochures, social media and their website and this for an indefinite period. They will be kept as long as they are relevant and after that time will be destroyed or archived. Created at Brussels, on
(date)
For consent,
Name and signature:
Address (not compulsory): Email (not compulsory):
RCN Justice & Democracy Adolphe Maxlaan 13-17, 1000 Brussel +32 (0)2 347 02 70 – pedagogie@rcn-ong.be www.rcn-ong.be KBO Nr: 0454555163