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*This means your name is on the Sex Offenders Register or you are otherwise known to the Police or any Local Authority Social Services Department, or any employer, as being an actual or potential risk to vulnerable groups.
SHORT-FORM SELF- DECLARATION CONSENT

By signing this Short Form Self-Declaration & Consent Form, I CONSENT to the Producer using the personal information supplied by me above, as well as any health or medical information disclosed by me to the Producer prior to or during the production of the Programme:

• to safeguard my welfare and the welfare of the Producer’s personnel and other participants in the Programme and to make sure I am able to perform the services under my contract with the Producer and to enable the Producer to make any reasonable adjustments where necessary or possible; and

• to collect and use the personal information that I have supplied in this form to verify that information and share the information I have supplied with the broadcaster of the Programme, the BBC.

We only use this information if you give us your permission. You don’t have to give us this information, but if you don’t you may not be able to take part in the Programme. If you change your mind, you can withdraw your permission at any time by emailing us.
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