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Keeping it Real | Kia Pono te Tika - Forum for Champions: release consent form

Thank you for agreeing to be in photos and/or video footage for Te Pou.

We must ask for your permission to use your image and/or video footage. If you are happy for us to use your image and/or video content, please complete this release consent form below.

You may request a copy of the image(s) and/or video Te Pou has of you at any time by contacting info@tepou.co.nz. 

If you have any questions about this form, please email communications@tepou.co.nz. 

Te Pou’s privacy policy can be found on our website

Photo and video content taken at the Forum for Champions event on 17 September 2025 may be used to promote Keeping it Real | Kia Pono te Tika at Te Pou.

I acknowledge and agree that my photos and/or video footage may be used on various Te Pou channels, including as:

  • Te Pou Facebook and LinkedIn accounts
  • Te Pou website
  • Te Pou e-bulletin
  • Photos and/or video footage of me will be used in publications as above that are freely available to the public.

 I understand the following conditions:

  • I will not be paid for the use of photos/footage/audio of me
  • I do not agree to any photograph or footage of me being used for any purpose other than what is mentioned above.
  • My personal details will not be shared with any third parties (unless otherwise agreed in writing)
  • I confirm that I am over the age of 18 years.

By signing this consent form, you acknowledge that your employer/organisation is okay with your image/video footage being used for the above purposes.

If at any stage you want Te Pou to discontinue the use of your material, please contact the team communications@tepou.co.nz to discuss options. Please be aware that printed and distributed material may not be able to be retracted after publication.