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heartfoundation.org.au|Helpline 13 11 12

Use of Personal Information Consent Form

Important: This page outlines how the Heart Foundation will use and manage your Personal Information (as defined in the Privacy Act 1988 (Cth)) as well as the Heart Foundation’s position with respect to liability. By continuing, you confirm that you have read these terms and conditions and consent to the proposed use of your Personal Information as set out below:   

You grant permission to the National Heart Foundation of Australia ABN 98 008 419 761 (Heart Foundation) to collect and use the following information about you (Personal Information) on the terms and conditions set out below:

  • My Story (or Case Study) 
  • Photographs, film or recordings of me in any medium 
  • Verbal or written quotes provided by me
  • Biograhpical information about me, and/or details of my medical conditions and medications
  • Any other form of Personal Information, such as contact details

Terms and Conditions - Use of Personal Information

You agree to the following terms and conditions:

1. The Heart Foundation will only use my Personal Information for the following purposes (Permitted Purposes):

  • a. publication and display in, but not limited to, a variety of Heart Foundation related national publications;
  • b. the promotion of health awareness and fundraising activities;
  • c. use in the Heart Foundation’s Annual Review;
  • d. use in advertisements promoting the Heart Foundation, heart health stories or fundraising activities;
  • e. research;
  • f. publication in a variety of formats including, but not limited to, printed publications, and electronically on the Heart Foundation’s websites (the Promotional Formats); and
  • g. provision of rights to any service provider engaged in the production of the Promotional Formats allowing them to use any DVD or photographic material produced for their own marketing purposes, including, but not limited to use in show reels and inclusion on websites, and social media sites.


2. The Heart Foundation may, from time to time, provide my Personal Information to contracted third parties, media (e.g. newspapers) and design agencies for the sole purpose of giving effect to the Permitted Purposes.


3. My full name may be used by the Heart Foundation in some cases to describe my Personal Information.


4. No royalties or other payments will be received from the Heart Foundation for the use of my Personal Information, either locally or internationally. I agree that I provide my Personal Information to the Heart Foundation on a voluntary basis.


5. I may at any time contact the Heart Foundation to request that my Personal Information no longer be used for some or all of the Permitted Purposes. On receipt of this request, the Heart Foundation will cease (and will use its best efforts to ensure that any media and design agencies engaged by the Heart Foundation using my Personal Information, cease) to use my Personal Information. I acknowledge and agree that the Heart Foundation may not be able to withdraw all current publications already featuring my Personal Information from circulation. In the event of my death, my next of kin may exercise the same rights held by me, under this clause 5.


6. Except as set out in these terms and conditions and in accordance with the Heart Foundation’s Privacy Statement below, my Personal Information will not be provided to a third party for any other use without my written consent.


7. If I identify as an Aboriginal and/or Torres Strait Islander person, I understand that:

  • a. Images of or references to Aboriginal and Torres Strait Islander peoples may appear in materials created under the Permitted Purposes noted above, and these materials may be used into the future;
  • b. the Heart Foundation may include warning text indicating that the materials may include references to and/or images of Aboriginal and Torres Strait Islander peoples who have passed away;
  • c. the Heart Foundation will where reasonably practicable, if requested by me or my next of kin, use my mourning name to identify me in updated materials after being notified of my death.


8. Content provided to the Heart Foundation may be edited for length, accuracy, clarity and creativity to be used in any medium as the Heart Foundation sees fit.

 
Participation and Liability

You agree to release the Heart Foundation from all liability for any loss, damage, expense or personal injury which may be sustained by you by reason of any neglect, act, omission or failure on the part of the Heart Foundation or its servants, agents, volunteers, employees or any other persons as a result of or in connection with your participation in the collection of and use of your Personal Information.

 
Privacy Statement

Your Personal Information is being or has been collected by the National Heart Foundation of Australia ABN 98 008 419 761 (Heart Foundation, we, us, our) to facilitate services requested by you and /or to keep you informed about Heart Foundation related activities. We respect your privacy and embrace the principles contained in the Privacy Act. We may contact you in the future for the promotion of heart health messages and programs, research, fundraising purposes and invitations to events.  If you attend our events you may be photographed or filmed and images &/or audio may be used in various mediums to promote the Heart Foundation.   Please tell event staff if you do not wish to be photographed or filmed.  Personal details may be provided to third parties where required by law or for the purpose of facilitating services contracted by us, in so doing your personal information may be disclosed to overseas recipients.  Further information is available in our Privacy Notice or on request.  Communications from us may include mail, email, social media, SMS or telephone contact and may also include messages on behalf of event sponsors and other third parties. By providing your information to us you agree that you have provided your indefinite consent to this contact.  You may withdraw consent at any time though in doing so we may not be able to provide you with services requested. The Heart Foundation will not disclose your information to any third party for their marketing purposes.

If you do not want to receive further communication from us (other than information that relates to this service) or if you have any questions about privacy please contact our Privacy Officer via GPO Box 9966 in your capital city, privacy@heartfoundation.org.au   or by calling 13 11 12.  Our APP privacy policy is set out in our Privacy Notice and details how you may complain about privacy issues and how we would deal with that complaint.  It also explains how you can access, correct or update information we hold about you. A copy of our Privacy Notice is available at www.heartfoundation.org.au or on request.  [HFPS01-190107-F]

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