Media Consent form

Family Media Consent Form

"*" indicates required fields

Step 1 of 2

Name of child referred to Shooting Star*

Your email*

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

Do you give consent for Shooting Star to use images, videos and testimonials of your family in our own publications (e.g. our supporter magazine, Shine), our website, email marketing, our shops and social media channels? (If you choose yes, you have the option of telling us if there’s anyone in your family who doesn’t give consent.)*

Yes – I give consent

No – I do not give consent

This consent covers routine use on the channels listed above. If we want to use your photos or footage for major appeals or materials that will be widely distributed or used for a long time, we’ll ask for your approval first. Please note that we cannot guarantee your photos, footage, or interviews will be included in any publicity or fundraising materials.

Consent to share outside of Shooting Star*

We sometimes share family stories and images with external supporters such as the media, charities, or corporate partners. We always seek your consent first (this is referred to as third party consent). If you agree, we may need to provide additional details (e.g., your surname), which we’ll discuss with you. Please note we cannot guarantee access to third-party footage or that it will be published.

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

No – I would not like to be contacted about third 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 in your family are you giving consent for

Please list the full names of everyone in your family you are giving consent for.*

This could include yourself, partner, child supported by Shooting Star, siblings, grandparents, aunts, uncles etc. Click the plus icon to add another person.

First

Last

Relationship to child

Please list the full name of anyone in your family who does NOT give consent.*

Click the plus icon to add another person. If you do not need to list anyone here, please write n/a in the boxes.

First

Last

Relationship to child

If there are any other instances where you would prefer us not to use your photographs / footage / interviews, or any information that’s 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: 12/03/2026.

By submitting this form, you are giving media consent for two years. Please 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.