Tell your story – The Active Wellbeing Society

Tell your story

The Active Wellbeing Society want to collect a range of feedback, stories, images, and videos to help us understand the experiences of our communities. Pictures and stories help us record, evaluate, and demonstrate the impact of our projects to partners, and funders. We also want to give individuals and communities a platform to share their experiences, tell their stories and help inspire others.

By completing this form, you give us permission to use your image, video, quote, or story in a range of communications, including but not limited to social media and our website, booklets, newspapers, presentations, and funding applications, for up to three years. We may also share your image, video, quote, or story with our partners for the purposes of promoting our work and the work of our partners.

We will check in with you and share a draft before publishing your story. If you have any questions about the form, please speak to a member of our staff in person or contact: 0121 728 7030 or [email protected].

Please use the space below to tell your story. You can use the prompts below to guide you or tell us about your experiences in your own way.

• Tell us a bit about yourself… For example, how old are you? What do you enjoy doing? • How have you been involved in one of our projects, groups, services, events, or other activities? • What does it involve and what do you enjoy about it? • How has this made a difference to you? What impact has it had on your life? Is there anything else you would like to share?

About your consent

I am giving consent for *

Your name

I give consent for use of my *

Image
Video
Quote
Story

(Please select the options you are happy with)

If your consent is related to an image/video you have uploaded, please let us know at what event or session the image/s were taken

Can I remain anonymous? You can choose to have your real name published (first name only) or remain anonymous (in which case, we will use a false name). Please select one of the following options: *

Are there any identifying features you do NOT want included in our communications work? *

I am happy to give permission:

Please note, the date of given consent is when the form is submitted.

Age *

Gender *

Ethnicity *

Postcode *

Contact number *

Your agreement - by signing below and submitting this form and your personal details, image, video, quote, or story you: • Permit us to store your information and contact you by these means if we need to obtain further information. • Agree that your image, video, quote, or story becomes the property of the Active Wellbeing Society so that we can use these in a range of communications, including sharing with partners and media organisations as described above. • Acknowledge that you have read our privacy notice and consent to our processing your personal data in accordance with it. You will NOT be entered into any digital marketing emails or databases by completing this form. *

Data protection: The personal information that you provide here will only be used by the Active Wellbeing Society to contact you about sharing your image, video, quote or story in our communications work. We will not store your data for any longer than three years, starting from when you submit this consent form to us. Relevant partners who may receive our communications include but is not limited to: Birmingham City Council, Solihull Metropolitan Borough Council, West Midlands Combined Authority, Sport England, National Lottery. You can read our privacy policy at: www.theaws.co.uk/privacy-policy. Right to withdraw consent: if you wish to withdraw your consent, you can do in writing to [email protected]

After clicking submit, you will receive a confirmation message. If this does not appear, please check all fields are filled in correctly and try again.

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