======SLQ Consent Form======

=====SLQ Consent Form=====

**I give consent** to the Library Board of Queensland, its employees, agents or partners (‘State Library’), to use and retain my/my child’s (‘the Participant’):

  * Name, image or recording (‘Record’); and/or
  * Personal property (including artefacts) and/or copyright material (‘Material’)

**I understand that:**

By giving consent, State Library can use and retain my Record and/or Material for:

  * Public relations, promotion, advertising, reporting and planning, commercial activities;
  * Use by the media in relation to activities that show me in a positive way; and
  * Any additional activities identified in a Schedule accompanying this Consent Form.

My consent will continue until withdrawn in writing. If, at that time, State Library is using my Record or Material, or has contractual obligations in relation to my Record or Material, the consent will continue until the use or the obligations end.

‘Use’ includes:

  * to create, make copies of or reproduce or retain in any form; and
  * to distribute, publish or communicate publicly, privately or commercially in any form in whole or in part.

‘Retain’ means:

  * State Library may use the Record or Material unless I withdraw my consent;

State Library will not pay me for giving consent or for the use.

This Consent Form does not transfer ownership of copyright to State Library. 

Nothing in this Consent Form limits the rights that the State Library has in relation to the Record or Material under any other law.

<form>
Action mail appliedcreativity@slq.qld.gov.au

static "My consent is subject to the following conditions and/or limitations: (Please select any that apply)"

select "Please select an option" "No conditions or limitations|Not for commercial use (eg merchandising, publications for sale)|Only the following formats (please select any that apply below): "

Only the following formats (please select any that apply):
yesno "Photographic images" 
yesno "Video recordings"  
yesno "Physical items (eg letters, artefacts)"
Textbox "Other (please specify)" !
Textbox "Cultural considerations (please specify)" !

Fieldset "Participant details"
Textbox "Name" 
Textbox "Home Address" 
email "Your E-Mail Address"
Fieldset "If the name of the Participant is used it should be:"
select "Please select an option" " Full name|First name only| No name|Other (please specify below)"
textbox "Name to use:" !


Fieldset "Parent/Guardian details (If the Participant is under 18 years or has a guardian appointed)"
Textbox "Name" !
Textbox "Home Address" !
email "Your E-Mail Address" !

Fieldset "Confirmation of Participant or Parent/Guardian, if applicable"
yesno "Please tick the box to confirm your consent"
Date "Date"

Fieldset "Identifying outfit/features"
Textbox "Text" !

submit "Submit Form"

</form>

=== Why am I filling in this form? ===

State Library values your privacy and we are asking for your consent before we use your personal information, including your photograph or copyright material, as part of our commitment to the Information Privacy Principles set out in the Information Privacy Act (2009). This Consent Form authorises State Library to use and retain your name, photograph, recording (“Record”) and any specified personal property or copyright material (“Material”) for the purposes outlined in the form, subject to any conditions/limitations you apply.

=== Conditions and limitations ===

The Consent Form allows you to place conditions and limitations on the State Library’s use of your Record and/or Material, for example:

  * Cultural conditions/limitations – for example, you may wish to remove an image for a period of time following the death of an individual or for a period of mourning or you may wish to limit the use of sacred or cultural material.

  * Other conditions/limitations – for example, you may not wish your photograph to be used for commercial purposes.

=== What if I give my consent and later change my mind? ===

You can change or withdraw your consent in writing at any time. Changes however, will only apply from the date State Library receives your request. Any existing publications, productions, presentations or promotions that use your Record or Material will not be withdrawn from use. To change or withdraw consent in writing, contact:

**State Library of Queensland Privacy Officer** 

State Library of Queensland 

PO Box 3488, South Brisbane Qld 4101 

t 61+ 07 3840 7780 

e privacy@slq.qld.gov.au 

=== Do I still own copyright in my material? ===

Yes you do. By signing the Consent Form you do not give State Library ownership of copyright or other intellectual property rights in your material. You simply give State Library permission to use your material for the purposes mentioned in the Consent Form.

=== Privacy Act ===

The Queensland Government’s Information Privacy Act (2009) regulates how personal information is collected, stored, used, disclosed and amended by the public sector. You can obtain further information about your privacy rights, or access a copy of the Information Privacy Act 2009 on the Office of the Information Commissioner’s website at [[http://www.oic.qld.gov.au/about/legislation]]. If you have any questions about privacy practices at the State Library, please email us on privacy@slq.qld.gov.au or phone +61(0)7 3840 7780.