Juiced TV : Media Consent Form (U 18)

Juiced TV – Media Consent and Release Waiver

Under 18

I, the Parent/Carer or Guardian of the Child confirm my agreement to the terms of this Media Consent and Release Form

a) Consent to Use of Content

Give my consent and permission for Juiced Enterprises Pty Ltd and its related entities, representatives, officers, employees, sponsors, supporters (including the Children's Hospital Foundation) and volunteers (Juiced TV), the irrevocable and perpetual right to use, reproduce, adapt, broadcast, licence and disclose recordings or images of my Child and their name in any form or medium (Content) throughout the world, for purposes in connection with:

i) the activities of Juiced TV, including the Juiced TV show and educational activities; and

ii) Juiced TV's sponsors and supporters, including hospitals, hospital foundations and corporate entitiespublicising their association with Juiced TV.

This includes distribution and publication across a range of channels, including but not limited to:

Hospital Patient Entertainment Systems (PES);

The Juiced TV application;

Display within hospital environments;

Public platforms including YouTube;

Social media platforms including Instagram, LinkedIn, Facebook and TikTok;

Juiced TV websites and digital platforms;

Marketing, promotional and fundraising materials;

Distribution to major donors, partners and supporters; and

Select external media outlets.

b) Waiver of Rights

Acknowledge that for the benefit of Juiced TV, I waive any rights that my Child, I or any person associated with my Child may have in connection with the use of the Content, including any right of approval, right to claim remuneration or compensation, or right to claim copyright, moral rights or any other intellectual property rights in respect of the Content. This waiver does not affect any rights you may have under the Privacy Act 1988 (Cth), the Information Privacy Act 2009 (Qld), or any other applicable privacy legislation, including your right to withdraw consent, access your information, or make a privacy complaint as set out in section (h) below.

c) Authority

Confirm that I am authorised to give this consent on behalf of the Child.

d) Sensitive Information Consent

Acknowledge that, as the nature of Juiced TV Content relates to a child’s experiences in hospital, Juiced TV may collect information that is considered “sensitive information” under the Privacy Act 1988 (Cth) and the Information Privacy Act 2009 (Qld), including health information.

Accordingly, I acknowledge and agree that:

i) the filming and associated activities may involve the collection of health information, including (but not limited to) the fact that the Child is or was a patient, the nature of their treatment or condition (if disclosed), and the Health Service at which they are being treated;

ii) this constitutes sensitive information under applicable privacy legislation; and

iii) I provide express consent to the collection, use and disclosure of this sensitive information for the purposes outlined in this form.

e) Use of Technology Providers and Overseas Disclosure

Acknowledge that Juiced TV uses a range of third-party technology service providers to produce, store and publish Content. While many of these providers are located in Australia, some are located in the United States or other jurisdictions, and in some cases (such as content hosted on YouTube) may be stored globally.

By signing this form, I acknowledge and agree that:

i) Juiced TV may disclose personal information to overseas recipients;

ii) Juiced TV will not be required to take steps to ensure those recipients comply with the Australian Privacy Principles;

iii) the above consent is agreement for the purposes of section 33 of the Information Privacy Act 2009 (Qld); and

iv) Juiced TV will not be liable under section 16C of the Privacy Act 1988 (Cth) for any act or practice of an overseas recipient that would breach the Australian Privacy Principles.

f) Third-Party Use and Loss of Control

Acknowledge that the Content may be shared with Children's Health Queensland, Health Services and the Queensland Health Department in connection with the purposes outlined in section (a) above.

Acknowledge that once Content is published or made publicly available, it may be accessed, copied, shared or redistributed by third parties beyond Juiced TV’s control.

While Juiced TV will take reasonable steps to remove Content from its own platforms if consent is withdrawn, it may not be able to prevent or require the removal of Content that has already been copied, downloaded or reshared by others.

g) Privacy Policy

Acknowledge that further information about how Juiced TV collects, uses and manages personal information is available at: https://www.juicedtv.com.au/privacy

h) Your Rights

Understand that I have the right to:

request access to the personal information Juiced TV holds about my Child;

request correction of any inaccurate or incomplete information;

withdraw consent for future use of the Content (noting this will not affect prior use); and

make a complaint if I believe personal information has not been handled appropriately.

Contact for all privacy-related requests:

Email: hello@juicedtv.com.au
Phone: 0401 416 649

Juiced Enterprises (ABN: 81 168 463 189)

Unit 5/19 Musgrave Street, West End, Brisbane QLD 4101