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Media Consent Form

Please fill in all the details, sign and date to give your consent for media use.

Personal Details

I hereby give consent for my image to be used for the purpose of promoting the work of Benetas, its services and programs.

I understand that my images may be published for use by Benetas in their promotional activities such as newsletters, posters, brochures, internal advertisements, and on social media such as Facebook in perpetuity.

If signed by a guardian, family member or an authorised person on behalf of a client, please include your details: