Media Consent Form

Your Surname and Name (required)

Child/Client Name (SURNAME and NAME) (required)

Address (required)

E-mail Address (required)



Do you give Swim Lab International permission to take photographs and/or videos of me (in case of a child of them)? (required)
Yes, I give Swim Lab International permission to take photographs and/or video of me (of my child)No, I do not give Swim Lab International permission to take photographs and/or video of me (of my child)


Do you give permission for Swim Lab International to store photographs and/ or videos of myself (or child in case of a child) on our password protected hard drive? (required)
Yes, I give Swim Lab International permission to store photographs and/or video of me (of my child) on our password protected hard driveNo, I do not give Swim Lab International permission to store photographs and/or video of me (of my child) on our password protected hard drive


Do you give Swim Lab International permission to use photographs and/or video of myself (or child in case of child) for educational, reporting, marketing and promotional purposes, in both online and offline format? (required) *To use Trexo Plus must answer ‘Yes'
Photographs, pictures, videos, audios or any promotional material appearing on our Website, brochures, advertising and/or publicity materials are used to display the experience and results we obtain for our clients.

During therapy sessions, members of our team, representatives, employees, other external film, or photography crew/s, crews of other websites, communication or broadcast channels or any other medium for dissemination of information, members of the press, media, production houses, network and/or any other person/s duly authorised by Swim Labs International may take photographs and/or pictures, film videos or record audios of clients undertaking therapy or other aspects of the organised weeks for promotional, publicity or informational purposes using various photography, lighting, filming, recording, sound and/or other production equipment, apparatus, kits or accessories. These photographs, pictures, videos, audio and/or other promotional material may be used on our own Website, other websites, media or broadcast channels, or in books, magazines, brochures, articles, newspapers, periodicals, on television, in documentaries and/or films or in advertising and/or any publicity material or mediums whatsoever of Swim Lab International and / or by any such organisations and / or person/s duly authorised by Swim Lab International.

Yes, I expressly waive the condition of obtaining your prior consent and / or asking for payment/ remuneration in respect of such photographs, pictures, films, documentaries, videos, audios and/or other promotional, publicity and informational material/s.No, I do not expressly waive the condition of obtaining your prior consent and / or asking for payment/ remuneration in respect of such photographs, pictures, films, documentaries, videos, audios and/or other promotional, publicity and informational material/s.

Your signature

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