Media Consent form

Media Consent Form

"*" indicates required fields

As a charity, it’s really important that we raise awareness of Shooting Star Children’s Hospices to help fund our work and to ensure families are aware of us. The personal experiences of families supported by Shooting Star Children’s Hospices are the most powerful way of doing this.

Do you give consent for Shooting Star to use images, videos and testimonials of you and your family in our own publications, our website, email marketing and social media channels?*

Yes – I give consent

No – I do not give consent

This consent allows day to day use on the channels listed above. We will check with you if we’d like to use photographs and / or footage for a fundraising appeal, campaign or on collateral that’s large scale or set to be in circulation for a fairly long period of time. We cannot guarantee that any photographs / footage / interviews undertaken will appear in publicity or fundraising materials.

Name of child known to Shooting Star*

Your Email*

We will send you an email confirmation of your responses for your records

Occasionally we are asked to share images and stories of families with external supporters (third parties) such as local and national press, other charities or a corporate supporter. We always contact families before sharing details on these occasions.*

If we have been asked to share a story and / or photographs / footage with the media and you have agreed to this, we may need to disclose further information (e.g., the family surname), but this will be discussed with you. We cannot guarantee that we will be able to share any footage with you captured by a third party, or that it will appear at all.

Yes – I am happy to be contacted about potential 3rd party requests

No – I would not like to be contacted about 3rd party requests

Thank you, please submit this form so we can keep our records up to date. Please be aware that we may still capture photos of your family at Shooting Star events, but these will only be shared with you. Please contact us if you have any questions about this.

Who you are giving consent for

Please list the names of all family members you are giving consent for.

Please list the full name of everyone you are giving consent for*

If anyone is over the age of 16 and able to give consent please confirm that they have also given consent before adding them to this form. Click the plus icon to add another person.

First

Last

Does anyone in your family NOT wish to give consent:*

Yes

Please list their full names.*

Click the plus icon to add another person.

First

Last

If there are any instances where you would prefer us not to use your photographs / footage / interviews, or any other information that is important for us to know, please specify here:*

Media consent is valid for two years, which will start from the date you complete and submit this form: 22/07/2025.

You only need complete this form once every two years. Email us at press@shootingstar.org.uk if you would like to withdraw consent or if you have any questions. You can also speak to a member of our Care Team who will get in touch with us.