Royal College of Anaesthetists (Rcoa) and Royal Photographic Society (RPS)

Royal College of Anaesthetists (RCoA) and Royal Photographic Society (RPS)

‘In Safe Hands’ Photography Competition 2017

CONSENT FORM

About the Royal College of Anaesthetists

The Royal College of Anaesthetists is a professional body and registered charity with approximately 17,500 fellows and members in the UK. It is responsible for many aspects of training in hospitals, and sets and runs the postgraduate exams for doctors to become anaesthetists. It sets standards for anaesthetic practice across the UK and works with government and the NHS to improve patient care.

About the Consent Form

A consent form establishes a contract between the photographer and the subjectand defines how and where photographs may be used. It is entirely up to you whether or not you take part. Please do not feel under any pressure. If you need more time to decide, please ask.

To be completed by the subject

By signing the consent form you are stating that you are happy to have your photograph taken for this photography competition and you agree for your image to be used by the Royal College to:

-Display the photograph on websites that are related to or promote RCoA and/or anaesthesia;

-Allow third-parties (such as but not limited to other medical educational establishments, news outlets) to share the photograph with the wider public to promote the RCoA and the Specialty;

-Use the photograph on the Internet and in Social Media in support of the RCoA and the Specialty;

-Use the photograph in the Royal College of Anaesthetist’s internal and external communications materials including but not limited to web sites and web publications, fact sheets, fund raising publications, multimedia, presentations and membership services, annual report and printed member publications;

-Retain a digital and hard copy of your photograph that will be archived in the College’s photo library and accessible to College staff via the College internal online photo archive.

I understand that no fee is payable to me by the Royal College of Anaesthetists, or any otherperson, in respect of the material, either now or any time in the future. I understand that I will haveno copyright claim on the material. I understand that my name will not be made available publicly with the photo unless I give permission. I confirm that the purpose for which the material will be used has been explained to me verbally, in terms that I understand.

To be completed by parent/guardian if subject is under the age of 16.

Name:
Signature: / Date:
Place/Address where photo/s is taken:
Email or contact telephone:

If you have any queries please contact Heather Rogers (RCoA 25th Anniversary Programme

Co-ordinator) Direct Line: 020 7092 1562

Royal College of Anaesthetists

Churchill House, 35 Red Lion Square, London WC1R 4SG

Tel 020 7092 1559 Email Website

Twitter@RCoANews | Find us on FacebookPage 1 of 2