Consent for photography and videography - Debra Ireland

Consent for Debra to use your images and audio-visual recordings

Images and recordings enhance and illustrate our stories, making them inspiring for our audiences and more accessible to the media. The terms and conditions on the next page explain with more detail how we will use and store your photos/videos/audio recordings (referred to as images/recordings).

In order to give us your consent, please complete and sign this form (one per adult) below.

If you are responsible for a child under 18 years of age, a parent or guardian must sign this form on their behalf.

Terms and conditions

What am I committing to?

I understand that:

  • By signing this form, I allow Debra the absolute right and permission to store and use my images/recordings and personal information for inclusion in any of its promotional materials, in print and online, or any of its media PR work, including all alternative edits, cut downs and revisions to promote and illustrate its work.
  • I release Debra, its contractors, its employees and any third parties involved in the creation, publication or broadcast of my images/recordings from liability for any claims by me or any third party in connection with my participation or the participation of the children named in this form.
  • Images/recordings and any other personal information I provide, can be used in all forms of media, as part of Debra’s work and campaign activity, including but not limited to website, TV, cinema, Internet, PR, press, print, magazines and editorial. These images/recordings can be seen outside the Republic of Ireland.
  • Editing may be required by Debra or by agents authorised by DEBRA Ireland for quality or technical purposes.
  • Images/recordings and any other personal information I provide, can appear without my specific knowledge.
  • Once my images/recordings are published in print they cannot be removed.
  • How my information, images/recordings are used by third parties is beyond Debra’s control and sometimes this happens without the organisation’s knowledge.
  • My images/recordings may be used alongside a story that is not specifically about me.
  • Any images/recordings and personal information will be stored securely in appropriate file formats on servers belonging to Debra.
  • Debra is committed to processing personal information in accordance with relevant data protection laws. The personal data collected on this form will be held securely and used for administrative purposes and the purposes listed above.
  • My participation is entirely voluntary and there is no obligation on me to give my consent to have my voice or image captured.
  • My consent can be withdrawn by me at any stage in writing by emailing
How may we use your images/recordings?
  • Your images/recordings will be managed by the Communications team and used by us (Debra) to promote our work and campaigns supporting research into effective treatments for epidermolysis bullosa (EB) and, in the meantime, to doing everything possible to alleviate the difficulties experienced by people living with EB.
  • We sometimes allow partners we are closely working with to use images to publicise our work (for example the media or people who sponsor our work).
  • We will attempt to use your images/recordings in work that illustrates experiences close to your own (for example work focusing on care if you have used support services). However, occasionally we may need to use your images in stories different to your own experiences. There is space on the form for you to let us know if there are any sensitive issues/or ways where you would not like your images to be used.
  • No fees will be paid to people taking part.
Where may my images/recording be used?
  • Images/recordings can be used in all forms of media, as part of Debra’s work and campaign activity, including but not limited to website, TV, cinema, Internet, PR, press, print, magazines, and editorial. These images/recordings can be seen outside the Republic of Ireland.
  • Your images/recordings may be reproduced in digital media and promotional materials. Please be aware that once your image has been published in print, it cannot be removed.
How do we store your information?
  • Your images/recordings will be stored in our library together with quotes and details about your own experiences (if you have shared them with us).
  • You can find out more about your rights, how we use your personal information and how we keep your details safe and secure by reading our Privacy Policy. For more information or to change your preferences contact
  • We take your privacy seriously and promise to never sell your data.
How long are you granting consent for and how can you revoke your consent?
  • Consent is valid for three years from the date this form is signed.
  • Unless consent is extended, Debra will not use images/recordings after this date but may not be able to call back all previously used materials.
  • If at any point in the future, you would like your images/recordings withdrawn from the library please contact


Who do I contact if I have any questions?

If you have any questions or need to contact us, please email

Consent for Debra to use my images and audio-visual recordings

Please read through the following and tick all that apply to you(Required)
Are you under or over 18?(Required)
If you're under 18, your parent or guardian needs to fill out the next section.

Your details

Your full name(Required)
I have read the Terms and Conditions and fully understand their meaning and effect.(Required)
DD slash MM slash YYYY
Data protection and confidentiality statement(Required)
Debra respects your privacy and values the trust you place in us when giving personal information. We work within the guidelines of the Access to Health Records Act 1990 and the General Data Protection Regulation. The information you have provided will be kept by Debra and will be treated with the strictest of confidence. It will not be shared with a third party without your consent unless we have a statutory obligation to do so. For more information on how we use your data see our Privacy Policy on our website.