Havens Hospices Model Release Form

Media Policy and Consent for Publicity Form

At Havens Hospices, our specialist care is free but we can only exist because of the support and generosity of the community. Together, we’re ‘Making every day count.’

Terms of Use
Havens Hospices may share your photo/interview for promotional purposes across a range of platforms and materials for up to five years including:

  • Havens Hospices social media pages including Facebook, Twitter, Instagram, YouTube and LinkedIn
  • Trading in-store promotional materials
  • Promotional video
  • Charity publications such as newsletters, supporter letters and reports/applications for trusts and grants
  • Media press articles 
  • Havens Hospices website (www.havenshospices.org.uk) and eNews
  • Fundraising communications, including; talks, presentations, thank you letters, leaflets (including Lottery, Legacies, events and In Memory materials)
  • DD slash MM slash YYYY
  • Declaration

    I have read and understood the above and I give permission for Havens Hospices to use my photos/interview for up to five years.
  • DD slash MM slash YYYY