MEDIA / PHOTOGRAPHY PERMISSION FORM Form Code: HSW-F48

 HSWAGATA BUDDHA TOOTH RELICS PRESERVATION MUSEUM

MEDIA / PHOTOGRAPHY PERMISSION FORM

Form Code: HSW-F48

Event / Visit Title: ____________________________

Date: ____ / ____ / ______

1. PARTICIPANT DETAILS

   1.1 Name (or group name): _____________________

   1.2 Contact (optional): _______________________

2. PERMISSION

   I understand that photos and/or video may be taken during

   this event or visit.

   I agree / do not agree (please tick):

   [ ] I AGREE that photos or video of me may be used for:

       [ ] Museum website

       [ ] Printed materials

       [ ] Social media

       [ ] Reports to donors

   [ ] I DO NOT AGREE that photos or video of me are used.

3. CONDITIONS (OPTIONAL)

   Please write any conditions. Example: “No tagging my name

   on social media”, “Use only in printed reports”, etc.

   _____________________________________________

   _____________________________________________

4. SIGNATURES

   Participant (or parent/guardian if needed):

   Name: ________________________________________

   Signature: ______________ Date: ____/____/____

   Museum Representative:

   Name: ________________________________________

   Signature: ______________ Date: ____/____/____