Consent form

By completing this form you give permission to the National Axial Spondyloarthritis Society (NASS) to use photos, videos and written case studies about you. The photos, videos or written case studies may be used:
In printed marketing materials (such as a leaflet or guide published by NASS)
In a film (such as our exercise videos)
On the NASS website or social media channels (such as Facebook or Twitter)
In the media (such as to promote NASS in a newspaper article)
In printed or online advertising
By other organisations that want to promote NASS’ work (such as hospitals or a Rotary Club)
You are giving us consent in perpetuity but we will not usually use photos or written case studies that are more than three years old or videos that are more than six years old. You can withdraw your consent at any time by writing to NASS but NASS reserves the right to continue to issue printed materials (such as leaflets or guides) until stocks are depleted and the publication is updated.
Declaration:
1. I understand that I have a right to see any information held about me by NASS. I know that I may write to NASS at any time to request a copy of all information held about me.
2. I am aged 18 or over.
3. I understand that while NASS makes every effort to ensure all media coverage is positive, NASS does not have control over how a journalist or media outlet may portray me.
4. NASS will only pass my information to third parties with my consent or where they are required to do so by law or in accordance with the charity’s safeguarding procedures.
5. I understand that it is my responsibility to inform NASS of any change of name, address, telephone number or email address.

Question Title

* 1. Please complete your details.

T