Commonwealth Parliamentary Association, CPA Headquarters International Secretariat Richmond House, Houses of Parliament, London SW1A 0AA, United Kingdom. T: +44 (0)20 7799 1460 | F: +44 (0)20 7222 6073 | Website: www.cpahq.org | Email hq.sec@cpahq.org. For media enquiries: communications@cpahq.org.

CPA data consent form (GDPR/Photography/Video)

Thank you for your assistance. At the Commonwealth Parliamentary Association (CPA), we produce a wide range of communications and materials to inform Parliamentarians and Parliamentary staff about our programmes and our services. From time to time we take photographic images and video footage of subjects and use case studies/quotes from Members and staff which can include these images, film and personal information (such as name, region, job title) to enhance and illustrate our media applications and case studies to make them more accessible and inspiring for our audiences. We ask all participants in CPA events and activities to complete this form for data protection.

Full Name

Job Title Organisation

Address

Postcode

Email

Are you over 18 years of age? Yes No Please tick

• I hereby consent to the Commonwealth Parliamentary Association (CPA) recording my contact details above for the purposes of Communications regarding future CPA events and activities. I understand that my details will be held by CPA and not shared with any third parties.

• I hereby consent to the Commonwealth Parliamentary Association (CPA) to use any images or video footage taken at the event or location above that include me in the images or footage.

• I also consent to them being used for other marketing and publicity related purposes and used in other CPA publications and I understand that they may be published on the CPA website and social media sites.

• I understand that:

• my images will be held in accordance with the Data Protection Act;

• that the images of myself captured in the video recordings and/or photographs will be the copyright of the CPA and any other intellectual property which arises in the recordings will also belong to the CPA.

• I hereby agree to irrevocably assign all property rights in my performance and/or recordings to the CPA;

• I hereby agree to waive all moral rights in my performance in the film and/or recordings to the CPA.

• I can ask the CPA to stop using my images at any time, in which case they will not be used in future publications but may continue to appear in publications already in circulation.

• If the recording is going to capture me speaking (e.g. lecturing or presenting information), I also agree that I will only include any material in the recording which is the intellectual property (including copyright) of another party, if I have their permission or a licence to do so and irrevocably licence the CPA to use and sub-licence any copyright in the words spoken (once fixed by the recording).

Signed

or type if emailed Date

Data protection statement: By completing this form, you give us permission to use the images, video footage and any details that you supply to us in our media applications, which reasonably promote or advertise the CPA’s aims. This may include our printed publications including The Parliamentarian; adverts; audio-visual and electronic materials; social media; media and PR work; display materials; and any other media we may use in the future. The images and video footage will not be used for any commercial purposes outside of the CPA. Other than as specified above, the information that you give us here will only be used to contact you about the images or video footage that we have taken. We will not pass the details recorded on this form to any other organisation without your permission.

For CPA staff to complete (internal use only): Forms to be completed at all CPA events

Name of photo/video shoot

Location of event Date

Image/Video reference(s)

CPA staff name