Bliss multimedia consent and release form

Name *

Start typing your address and select the correct address from the dropdown results.

Address

We'll only use this to contact you with relevant information and if you opt-in to receive other Bliss updates.

Please list anything here. For example, this could include your location, or the age of your children.

I give my consent for Bliss and Bliss Scotland to use or capture footage, audio, photographs, words and other types of media (hereafter known as content) involving me and/or my baby.

I give Bliss and Bliss Scotland all rights to use content relating to me and/or my baby in Bliss materials, including but not limited to: Bliss information and marketing materials; on bliss.org.uk; on Bliss’ social media channels; on co-branded materials in support of Bliss’ aims, and in any future Bliss project.

This consent is given indefinitely but I can withdraw it at any time by emailing media@bliss.org.uk

I have discussed the above with the child's other parent/s (if appropriate). I am over 18 years of age.
Please tick the box to confirm you have read and agree to the above consent statement: *

Let's keep in touch

Your support helps the most vulnerable babies in the UK. We’d love to keep you updated with news about our work and ways you can get involved with Bliss. Are you happy for us to contact you:
By email *
By phone *
By text message (SMS) *

Your privacy


We (Bliss and Bliss Scotland) promise to keep your details safe and never pass them on to third parties for marketing purposes. Find out how we look after your personal data in our Supporter Promise. If you have provided a postal address we may occasionally contact you by post, but you can opt out of all communications from Bliss at any time by calling us on 020 7378 1122 or emailing fundraisingoperations@bliss.org.uk