Consent for Use of Images & Recorded Materials The planning and delivery of North East Link is being overseen by the Victorian Government’s North East Link Project (NELP). NELP produces publications and runs public events from time to time for the purposes of:   familiarising the public with the role and structure of NELP;  informing the community and stakeholders about the Project; and  collecting feedback about the Project from community members and stakeholders. 

NELP produces and distributes promotional material through such media as:  external publications such as reports, newspapers and magazines;  departmental publications such as Annual Reports, posters, brochures, newsletters, booklets and

displays;  television and radio segments or advertisements; and  intranet and Internet sites and official social media platforms such as YouTube, Twitter and Facebook. 

NELP may wish to use your photograph, video image, audio, and/or written work (Images & Recorded Materials) to promote its activities (and those of related Victorian Government Departments), including those outlined above.  No commercial use will be made of your Images & Recorded Materials by NELP or the Victorian Government. 

NELP respects your privacy and would like your consent to use your Images & Recorded Materials for the purposes described above. If you consent, this would be for an ongoing basis until you withdraw your consent in writing. 

NELP is committed to meeting its obligations under the Privacy and Data Protection Act 2014 (Vic), including the security of your personal information.  

NELP’s privacy policy is available at www.northeastlink.vic.gov.au/privacy and contains information about how to access or correct your personal information and how you may complain about a breach of your privacy. 

You can access to your Images & Recorded Materials and any other personal information held about you by contacting NELP at: Privacy Officer North East Link ProjectLevel 13, 121 Exhibition Street Melbourne VIC 3000 

Please ensure that you take a copy of this statement for your future reference. 

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Consent  I agree to and consent for the photography, video, audio or any other form of electronic recording identifying me and/or my child/ward, and any of my/our written contributions (Images & Recorded Materials), to be collected, stored and used by the North East Link Project (NELP), (or the Victorian Government), for publications and public relations activities as described in the Consent for Use of Images & Recorded Materials without acknowledgment, remuneration or compensation.  

I understand that the Images & Recorded Materials may appear in print, electronic or video media, and may be available to a global audience through the Internet and social media platforms. 

My consent is ongoing and I can withdraw my consent at any time by writing to: Privacy Officer North East Link ProjectLevel 13, 121 Exhibition Street Melbourne VIC 3000 

 Or by emailing: nelp.privacy@northeastlink.vic.gov.au

Name  ____________________________________________________________________________________________________

Address  -____________________________________________________________________________________________________ 

Email ____________________________________________________________________________________________________

Signature ___________________________________ Date ____/____/_______ 

For persons under 18 only: 

Name of parent or guardian ____________________________________________________________________________________

Signature of parent or guardian _________________________________________________________________________________

NELP agrees to only use the Images & Recorded Materials for non-commercial purposes such as those described in the Consent for Use of Images & Recorded Materials.  

For further information on how we collect, store and use your personal information, please refer to our privacy policy: www.northeastlink.vic.gov.au/privacy   

OFFICE USE ONLY

Name of project or event:

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Name and area of NELPstaff member responsible:

Identifying features [for identifying the individual in an image etc] for future reference if access is requested by an individual:

3Authorised and published by the Victorian Government,1 Treasury Place, Melbourne

North East Link ProjectGPO Box 4509, Melbourne VIC 30011800 105 105Community@northeastlink.vic.gov.aunortheastlink.vic.gov.au