Al-Madrasah Al-Hussamiyah (Sydney)

Student Media Consent and Release Form

This form seeks your consent for the use of photographs, videos and/or audio recordings of your child in accordance with the Privacy Act 1988 (Cth), the Australian Privacy Principles and our Child Safe policies. Please read carefully and complete all sections.

Purpose of Media Collection

We may capture and use images and recordings of students for educational, promotional and community purposes, including but not limited to:

Madrassah al Hussamiyah newsletters, reports and publications
Official Madrasah website and social media channels
Displays at Madrassah al Hussamiyah events and community functions (including miqaat)
Shared on the Idarut Ta’reef al Shakhsi (ITS) Website and by the Anjuman-E-Burhani organisation

Your child’s personal details (full name, address) will not be published with media without separate, specific consent.

Student Details

First Name	Last Name	Class

Parent/Guardian Details

Full Name Relationship to Student Phone Number Email Address

Acknowledgement & Signature

I confirm that I have read and understood this form and that I am authorised to consent on behalf of the student named above.

Signature:

Date: