menu
Supporter Consent
Consent
1
. My details
2
. My story
3
. Consent
4
. Photographs
Personal details
Your name
First
Last
Email address
Relationship to child or young person (if applicable)
Date of birth of person sharing their story
DD slash MM slash YYYY
Phone number
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Please tell us your fundraising story
For example, what fundraising did you do? Why did you fundraise for ShelterBox?
How much did you raise?
My identity
Please tick all boxes that apply
I agree for my real first name to be used
I agree for my real surname to be used
I agree for my real location to be used
I agree for my age to be used
I would like to be anonymous ie ShelterBox should change my first name, surname, location and any particular information that might identify me to protect my privacy and identity
My story
Please tick all boxes that apply
I agree for the words, information and story I have shared with ShelterBox to be recorded and stored in its case study library for a period of five years from the date on this form.
I agree that ShelterBox can adapt my words, information and story for marketing materials that are written as if they come from me, for example a fundraising letter or email written in my voice. I understand that if I tick this box, adapted versions of my words, information and story will be shared with me so they can make sure I am comfortable with what has been written.
Photographs
Please tick one box only
I agree that photographs of me may be used where my face can be seen
I agree that photographs of me may be used if my face cannot be seen
Photos of me cannot be used. I would like an actor or model to play me in photograph
My story in the media
I agree to be contacted by ShelterBox’s media team – via a project worker or appropriate representative of ShelterBox – to talk about being interviewed by a newspaper, website, radio or TV journalist.
Permission
I agree for my and/or the child’s (for whom I have parental responsibility) words, information, story, photographs, video and audio – as set out in sections in this form – to be used by ShelterBox and its partner organisations in printed, online or electronic publications, which may be shared publicly. Examples of these materials include, but are not limited to: posters, leaflets, brochures, adverts, emails, e-newsletters, blogs, web pages, social media posts, presentations, speeches, research or policy reports and press releases or other materials.
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