Person Depicted — Image Permission Form

NEW LEGENDA International Championship

Before you complete this form

Complete this form if you are identifiable in a photograph or video submitted to an international NEW LEGENDA Championship by someone else. This form is for permission to use your image in the stated ways. It does not transfer ownership of the photograph or video.

The person submitting the work must provide the work reference and explain the intended use. You may permit closed assessment without permitting public display or promotion. Optional permissions must be selected separately and are not preselected.

A. Work and person details

Championship / stage: __________________________________________

Nomination: ___________________________________________________

Work reference or upload ID: ___________________________________

Name of person submitting the work: _____________________________

Name of person depicted: _______________________________________

Email of person depicted: ______________________________________

B. Permission for closed assessment

Select one:

☐ I permit closed assessment. I give SUNSARA GROUP (“NEW LEGENDA”) permission to receive, securely store and show this image or video to authorised administrators and judges assigned to the Championship, solely to check eligibility, assess the work, moderate the process, record results and handle any review permitted by the Championship Rules. This permission does not include public display, marketing or use by sponsors.

☐ I do not permit the image or video to be used for assessment. I understand that the work may not be eligible for assessment if my image is necessary to assess it.

C. Optional public gallery permission

This choice is optional and separate from closed assessment. Select one:

☐ I permit public gallery display. NEW LEGENDA may display the identified image or video in the public gallery for the Championship or stage named above, viewable by website visitors without signing in. The gallery may show the nomination and work reference. It will not show my contact details.

☐ I do not permit public gallery display. My image or video may be used only for closed assessment if I selected permission in section B.

D. Optional promotional permission

This choice is optional and separate from assessment and gallery display. Select one:

☐ I permit the following promotional use only:

☐ NEW LEGENDA website or official social-media accounts

☐ Championship announcement or results content

☐ Other channel or purpose (describe): ______________________________

Attribution choice: ☐ Use my name ☐ Do not use my name

Permission period, if limited: ____________________________________

I understand that promotional material may be viewed, captured, shared or copied by third parties. This permission does not make me an ambassador, imply that I endorse a sponsor or product, or transfer ownership of the image or video.

☐ I do not permit promotional use.

E. Confirmation by the person depicted

By signing or taking the recorded electronic action below, I confirm that:

I am the person depicted, or I am authorised to act for them as specified below;

I have read the choices above and selected only the uses I permit;

my optional choices are voluntary and are not bundled with permission for closed assessment; and

I can ask to withdraw a future optional use by contacting sunsarasuvorova@gmail.com and identifying the work and permission. Withdrawal does not undo a use already made lawfully or guarantee removal of third-party copies, screenshots or shares.

Person depicted — full name: ____________________________________

Signature or recorded electronic affirmative action: ________________

Date: ____________________ Country: ________________________

F. Parent or legal guardian (complete only if the person depicted is under 18)

Name of parent or legal guardian: _________________________________

Relationship and authority: ______________________________________

I confirm that I am authorised to make the selected choices for the child named above. I have read this form and have selected only the uses I permit.

Signature or recorded electronic affirmative action: ________________

Date: ____________________ Email: __________________________

G. Contact and records

Permission questions or withdrawal requests: sunsarasuvorova@gmail.com. Please include the Championship, work reference, the person’s name and the specific permission concerned.

The submitted permission record should be linked to the relevant work and store the form version, selected options, signer identity, date and time, and the electronic acceptance evidence. Access is limited to authorised administrators. See the Privacy Notice for information about handling and retention of personal information.

SUNSARA GROUP

89 George Street, Suite 2168, Cape Town, Western Cape, 7140, South Africa