Consent Form

Thank you for sharing your story with Martlets, and/or allowing us to film you, take your photo, or to use images or footage you have sent us. It’s important that you feel the story accurately reflects who you are and your experiences. By sharing your story, you are making a big difference to the work of our charity and we greatly appreciate your support. 

Please complete the form below to consent to Martlets using any comments, footage and images you have provided. 

  • Consent

    I grant full rights for any words, film or photos obtained (including any reproductions or adaptations of images) to be used by Martlets for marketing and fundraising purposes. I am happy for you to use this material for (please tick all that apply):
  • I confirm that I have discussed the use of this material with my family/friends, particularly those I may have mentioned in my comments or who appear in images I have sent you.

    I understand that once my photo(s)/words are published and in circulation – for example, in a newspaper or on the internet via our website or social media – they may be copied and used by others.

    I am aware that if I, or my next of kin, wish to withdraw this consent at any time, I/we can do so by sending an email to (In this instance, Martlets will not use your words/photo/film footage again and will aim to prevent any third parties from publishing the content, although this cannot be guaranteed).

    I understand that Martlets will store this material on their internal database for three years and may continue to use it during that period. I am aware that after that time has elapsed further consent will be sought from me (or if relevant, my next of kin) for usage.

    Privacy Statement: Martlets will not sell or give your contact details to any other organisation to use for their own purposes unless requested to by law. We promise to keep your details safe, and we will only allow your information to be used by suppliers working on our behalf.

    To view our complete privacy policy, please click here.
  • This field is for validation purposes and should be left unchanged.