Media Consent Form

18yrs & over


    I hereby give my full and informed consent for House of Levi Intl to use images of me via the following channels (tick all you provide consent for):

    You have the right to withdraw your consent at any time. In order to do so, please contact us via email at info@holintl.com.

    Under 18yrs

      If you are under the age of 18, consent must be given or authorised by the holder of parental responsibility. Please fill out the below if you are signing on behalf of a person under the age of 18.

      As the holder of parental responsibility, I am signing on behalf of the named person above who is under the age of 18 and hereby give my full and informed consent for House of Levi Intl to use images of the named person above via the following channels (tick all you provide consent for):


      You have the right to withdraw your consent at any time. In order to do so, please contact us via email at info@holintl.com.