2016/2017Australian & International Competition Season

Media Coverage Consent Form

This document gives Re-Engineering Australia Foundation (REA) Ltd.and its international partner organisations permission to reproduce portions of sound, video clips or photographs of students taken in the course of their representative activities at REA managed events in Australiaand international events managed by others. This material can be used for purposes associated with the promotion of the REA FoundationLtd, its international partners and theprojects they manage. Permission is also granted to name individual students and the team and school they represent.

Student Name:Click here to enter text.School Name: Click here to enter text.

Team Name:Click here to enter text.Project Name: Choose from list

  • REA and its international partnersmay record sound and/or vision of me and my project work whilst I am taking part in REA related activities in Australian and overseas.
  • The REA Foundation and its international partner organisationsunderstands that I own the intellectual property rights in my sound and my vision and that this consent form is not meant to transfer my ownership.
  • I give permission to the REA Foundationand its international partner organisations to use my sound/vision and/or my name in relation to:

-Domesticand international related activitieswhich will assist with promotion of theREA and its international partners.

-Future media activities which would assist with REA Foundation and international partner organisationpromotion and any commercial purposes.

  • I can withdraw permission by notifying REA Foundation in writing.
  • I understand that by giving this permission, REA Foundationand its international partners can use my sound and/or my vision in any legal way it chooses, for the purposes described above and may continue to use it in the future unless and until you withdraw your permission in writing. It may reproduce them in any form, in whole or in part, and distribute them by any medium including the internet, CD-Rom or other multi-media uses.
  • I understand that the Re-Engineering Australia Foundation and/or and its international partnerswill not pay me for giving this permission.
  • I agree to notify REA Foundationof all approaches to you by any media, publicity agent, magazine, journal, television entity and seek approval for the representation of REAFoundation and its international partners by youin any publicity or media activity.

I have read and understood the above statementsand accept the above Terms and Conditions.

Signature of Student:Signature of Parent/Guardian:
(Only required if student under 16yrs)

Sign______Sign______

NameClick here to enter text.NameClick here to enter text.

DateClick here to enter a date.DateClick here to enter a date.

ABN:12 095 876 323 Unit 2, 3 Packard Avenue Castle Hill NSW 2154 Australia PO Box 136, Castle Hill NSW 1765

Phone: 1300 204 478 Int. Facsimile: +61 2 8079 0622 Email: Internet: