Disability Homestay Network Marketing Consent Form

Please read all the information on the page – or have someone read it to you – before completing the form.

What is this form for?

The Australian Homestay Network (AHN) is seeking your consent to capture, use and publish images, recordings and information about you (or a person you are representing) for the Disability Homestay Network program.

This may include photos, audio and video recordings, quotes, text, your name, age and state (“content”).

In this consent form, “AHN”, “we”, “us” or “our” means the Australian Homestay Network.

How will your content will be used?

You grant AHN the right to use, edit, reproduce, and publish content featuring you (or a person you are representing).

You agree that AHN may use the content for the purposes of advertising, media publicity, publication, general display or for any other business purpose. This may include:

printed publications such as brochures, booklets, fact sheets
display banners and posters
television, radio and newspaper advertisements and other media
internet pages (including our website https://disabilityhomestay.com/ and/or Disability Homestay Network social media pages).

Fields marked with an asterisk (*) must be filled in.

Who are you providing consent for?

Participant (Guest) Details

First Name *

Last Name *

Phone Number *

Email *

State *

Date of Birth *

Authorised Representative Details

You will be responsible for communicating the information contained on this form to the person you are representing to ensure they understand how their content will be used.

First Name *

Last Name *

Phone Number *

Email *

What is your authority to consent on the person’s behalf? *

Collection Notice

We are collecting this information so that we have a record of your consent for AHN to use photos and recordings of you and/or of individuals you have consented on behalf of.

We are committed to protecting your privacy and collect, store, use, and disclose personal information responsibly and transparently in accordance with the Privacy Act 1988 (Cth). If you would like to access or correct any personal information we have collected for this consent form, you can do so by emailing info@disabilityhomestay.com.

I acknowledge that I have read (or have had read to me) the information outlined above and understand it. *I understand I am not entitled to any payment (monetary or otherwise) or royalties in any from AHN for using my content. *I understand AHN cannot control unauthorised use of my content by persons not associated with AHN once it has been published or transmitted. *I understand that this consent is freely given and that I may withdraw my consent at any time by emailing info@disabilityhomestay.com. Otherwise, my consent will remain valid for an indefinite period from the date of signing this form. I certify that I have read and understand this consent form in full. *I agree to the terms and conditions outlined on this page. *