Image & Written Material Release Form

Thank you for sharing your content with us!

Please take a few minutes to complete this form, to make sure that we use your material exactly as you wish.

What is this form for? 

This release form is a legally binding agreement between you and LLLGB, giving us your permission to use your material (stories, poems, artwork, photos, videos etc).

You can specify how you want your material used, for example in our member publication Breastfeeding Matters, our other print publications, on our social media, website, or in other communications such as films. It protects you and LLLGB against your contribution being used in a way you have not agreed to.

You can choose if you would like to be credited for your images, or if you would like to remain anonymous.

LLLGB will only ever knowingly use an image or a piece of work to promote our mission. You can read about our mission and philosophy here.

We also offer you the option of giving permission for La Leche League International to use your image in their work, in which case LLLI and any of the 80+ countries where LLL is active may use it.

Who can sign?

If you are over 13 years old you can sign the form yourself. We need the signature of a parent, guardian, or carer to sign on behalf of anyone under 13.

Where can I read more about how you handle my personal information?

You can read our privacy policy here.

For all images – please check with the person who took the photo or video that they are happy for us to use it.

If it was a professional photographer they might hold the copyright.

Please also check that anyone else who appears in photographs or photos (besides your own young children) is happy to be featured.

LLLGB release form May 2018 onwards

Your name *

Name of child / young person under 13

Your Email address *

Section A - Breastfeeding Matters

If you have submitted your material for our member publication Breastfeeding Matters, please complete this section. If not, skip to Section B. 

I agree that LLLGB may use the following in Breastfeeding Matters:

My written materials

My artwork

My photos

Website - Breastfeeding Matters

We have a section on our website for selected stories from Breastfeeding Matters: https://laleche.org.uk/category/breastfeeding-matters/

Would you be willing to have your story in Breastfeeding Matters added to the website?

No

Yes - story only

Yes - story and images

If you answered Yes, how would you like your material to be credited on the website (whole name, first name only, initials, anonymous)? Please write here exactly how you’d like us to credit you.

If you are happy for us to use the images you have submitted for Breastfeeding Matters in other ways, please fill out the next section. If not, skip to Section C. 

Section B - Photographs/Images

Thank you for sharing your images with us. Good quality breastfeeding photos and other images related to our mission are extremely valuable in our work.

You may have shared your images with us on their own, or as part of your story in Breastfeeding Matters. Please indicate how and where we may use your photos/images. Please tick any that apply. If you don’t tick an option, we will not use your material in that format.

LLLGB’s social media (e.g. Instagram)

Printed resources (e.g. leaflets)

Our website (e.g. illustrating the breastfeeding information pages)

Photo/image credit

LLL does not normally credit photos on our website, leaflets, or social media unless specifically requested.

Would you like us to credit (include a name with) your images?

No

Yes

If the name for the credit is different from yours, please tell us who should be credited:

La Leche League International

Do you allow La Leche League International to use your material in their work? If you give your permission, it may be used in any of the 80+ countries where LLL is active.

Do you agree that LLLGB can share your material with LLL International?

Yes

No

How long your material can be used for

I understand that

• my materials may continue to be used for a period of 10 years from now. 

• LLLGB can contact me by email to request to extend this. 

• I can email GDPR@laleche.org.uk at any time to have my materials removed and my data deleted.

I understand and agree

Yes

Section C - please sign below to complete the form

Print Name *

Signature

Clear

Date *

Many thanks!  If you have any questions, or would like to change your responses at any time, please contact our Operations Manager at operationsmanager@laleche.org.uk

If you are human, leave this field blank.