Media and Work Sample Consent Form - Child/Student

Your child’s school is currently implementing *Maker’s Empire’s 3D Learning Program.

Maker’s Empire Pty. Ltd. and other attendees therefore seeks your consent to use photographic and digital images, video and audio recordings and work samples taken from you or your child for use in the following ways (‘the Agreed Purpose’): educational publications, in-app content, newsletters, websites, social media platforms, other related methods of promotion, any future editions and variations of the above, and both electronic and printed formats of the above.

Non-return of this form will be taken as a refusal to grant permission, and any record of your (or your child’s) likeness or work must therefore be discarded.

Consent

identified visual Your

I, acknowledge that I:

understand that Maker's Empire Pty. Ltd. does not guarantee that any photos, digital images, recordings or work samples of the individual who is identified below in the area marked, ‘Full name of the person/s photographed or who supplied work samples’ will necessarily be used;
understand that copyright in photos, digital samples, recordings or work samples of the individual who is identified below in the area marked, ‘Name of the person photographed or who supplied work’ will vest in Maker's Empire Pty. Ltd.;
understand that I will not be given the original of the photos, digital images, recordings or work samples of the individual who is identified below in the area marked, ‘Full name of the person/s photographed or who supplied work samples’;
consent to the publication, by Maker's Empire Pty. Ltd., or other attendees, of photos, digital images, recordings or work samples of the individual who is identified below in the area marked, ‘Full name of the person/s photographed or who supplied work samples’ for the Purpose with any reasonable retouching or alteration;
understand the Agreed Purpose of publication of images, recordings or work samples of the individual who is identified below in the area marked, ‘Full name of the person/s photographed or who supplied work samples’, including possible use on the Internet and in the media;

For parents/caregiver(s)

I, hereby consent to photographic and digital images and/or audio and visual recordings and/or work samples of my child. *

First

Last

(print your full name)

being used by Maker's Empire Pty. Ltd. for the purposes described above. *

First

Last

(print child's full name)

give permission for my child’s first name, age and/or year level and school to be identified (surname will not be published). *

I DO
I DO NOT

Your Email *

Name of School/Centre *

Date *

Signed: *

Clear Signature

*Maker’s Empire Pty. Ltd. is a South Australian based company that supports schools to integrate 3D design and 3D printing into their teaching and learning programs. The company provides 3D design software, curriculum resources and training for teachers and aims to help equip students with problem solving capabilities and critical and creative thinking skills to thrive in the future. Part of implementing Maker’s Empire’s 3D Printing Learning Program involves providing schools with resources and materials such as lesson plans, case studies, work samples and updates on how 3D printing technology is being used in schools.

For any questions, contact info@makersempire.com