Media Consent Form


Firstly, thanks so much for helping. We’d like permission to respectfully use your likeness in photographs, video, or other digital media, and your name and/or any interview statements or testimonials, to assist in our mission to help New Zealanders affected by SCI live independent, confident, productive, and FUN lives.


Please read on and sign below if you agree.


I hereby grant the New Zealand Spinal Trust (NZST) the right to use my likeness as described above.

Uses may include, but are not limited to, editorial, marketing and educational purposes, in NZST publications, grant applications and reports, newsletters, websites and social media pages.

I understand there will be no financial compensation for either my time or the use of my likeness, that I do not own the copyright of the materials, and materials may be used without restriction and in any format, unless I specify below.

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