Parent/Guardian Contributor Consent & Release Form for under 18s to

supplement ACTNOWFILM2 terms and conditions for submitting video
content: Play your part at COP27 - submit an entry to ActNowFilm2 | www.zero.cam.ac.uk
Event/Project: ACTNOWFILM2! A COP27 YOUTH VOICES PROJECT
Date of Event/Project: Closing date for submissions 16 October 2022, Anticipated date of
submission of finished film to COP27: 25th October, COP27 to be 7-18 November 2022.
Event/Project Organiser, Contact Details: Amy Munro-Faure, Engagement Manager, Cambridge
Zero. Email: info@zero.cam.ac.uk

Thank you for contributing to the Event/Project. By signing this form you agree to the following terms:

1. I hereby consent to the use of the recording of my child incorporated into the digital material my child has
prepared and submitted to the Event/Project (“Contribution”) for the purpose of incorporating in whole or
part the Contribution into the Event/Project and associated promotional material, the nature of which has
been fully explained to me.

2. I grant a non-exclusive licence to the University of Cambridge and The University of Bath (“the
Universities”) and all other participants in the Event/Project (and those authorised by them) to copy, adapt
and make use of the Contribution for the above purpose and for all reasonable non-commercial
educational and promotional purposes of the Universities, by all means and in all media (in whole or in
part, transcribed or otherwise), such use including but not limited to print and online publication and
broadcast, e.g. in University websites and social media such as YouTube, Facebook and Twitter.

3. I acknowledge and accept that my child will be credited where editorially appropriate (as determined by
the Universities) but it may not be possible for my child to be credited in all cases, for example where the
use of the Contribution is in short clip used as promotional material for the Event/Project. I further
acknowledge and accept that the Universities are under no obligation to use the Contribution and may edit
the Contribution as it sees fit.

4. To the best of my knowledge and belief, the Contribution will not infringe the copyright or any other rights
of any third party or contain any defamatory material. Should the Contribution contain third party material
such as others’ text or still or moving images or of anyone in an image, the copyright/personal data in that
content may belong to someone else, which means that I agree that I have obtained their
permission/licence/consent as applicable to include it in the Contribution and allow it to be used for the
purposes set out above.

5. I understand that I have the right to withdraw this consent at any time by emailing the Event/Project
Organiser named above, in which case the Universities will take reasonable steps to ensure that the
Contribution is not used by the Universities in future publications but may continue to appear in copies of
the Contribution already in circulation.

6. The information provided and/or described in this Form is to be used for the purpose described above and
is managed and stored by the University with my consent. Further information about the Universities’s use
of my personal information is at: https://www.information-compliance.admin.cam.ac.uk/data-protection/
general-data (for the University of Cambridge) and at
https://www.bath.ac.uk/corporate-information/university-of-bath-privacy-notice/ (for The University of
Bath).

1 of 1
Name of Child/Vulnerable Adult: Gonzalo A. Poma Calderón Name of
Parent/Guardian: Avelino Poma Laura
Signature of Parent/Guardian: Date: 6/11/2022

1 of 1