Photography and Filming Authorisation Form

Please fill in the following form if you wish to take any photos or film at Glen Eira Leisure facilities.

Submitting this form is confirmation of your understanding and agreement to the terms and conditions.

Please see reception to collect your filming authorisation wristband prior to commencing.

Date *

Press the down arrow key to interact with the calendar and select a date. Press the question mark key to get the keyboard shortcuts for changing dates.

Time *

First name *

Last name *

Email address *

Date of Birth *

Address *

Telephone *

Purpose of filming / Photography *

Terms *

That all direct footage participants have provided consent

That this form is completed correctly and the intended use is approved

That a Glen Eira Leisure staff member may request to view the footage to confirm direct and indirect footage of patrons

The content of the footage is not for commercial use (except under written approval from Glen Eira Leisure Senior management)

Please note this form is valid for 6 months from the submission date.
You must collect a new photography permission wristband from reception at the start of each visit.

Name of photographer

Please confirm you are a person. *

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Photography and Filming Authorisation Form

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