MUMU YOGA — OPTIONAL PROMOTIONAL FOOTAGE PERMISSION
Adult participants only. Complete the specific plan and choices BEFORE filming. No box is selected by default. Do not use this form for under-18s or as a condition of class attendance.

Controller/contact: Muriel Mueller trading as MuMu Yoga, 33 Cobham Road, Kingston upon Thames, KT1 3AE; mumuyoga8@gmail.com.

Participant name:
Participant contact email:
Filming date and agreed scene/session:
Exact footage and proposed edit/purpose (complete before presenting the form):
First publication date and removal date (maximum 12 months later):

I separately choose whether to permit each identifiable element:
[ ] My face/image in the agreed footage
[ ] My voice in the agreed footage
[ ] My name as stated here (otherwise do not identify me by name):

I separately permit the following channels only:
[ ] MuMu Yoga website at mumuyoga.com and www.mumuyoga.com
[ ] Owned social account — write its exact name/URL and whether organic posts or paid advertising:
[ ] Additional owned social account — exact name/URL and organic posts or paid advertising:
No unnamed platforms, paid advertising, AI processing, sensitive health labels or materially different purpose are included. Obtain a fresh choice for any such change.

Permission covers only the agreed scene and reasonable trimming, captioning and presentation consistent with that description. Do not misrepresent my words or imply a medical outcome, diagnosis or endorsement I did not give. Let me see the proposed identifiable edit before publication and record my approval below.

I may decline without losing class access or paying a different price. This is separate from booking terms and existing testimonial permission. I can withdraw by contacting the email above. New use stops promptly and material controlled by MuMu Yoga is removed within 30 days; third-party reposts/caches cannot be guaranteed removed. My legal rights are unaffected.

Unused raw footage: delete within 90 days of filming. Raw footage used in an approved edit: delete within 90 days of edit approval. Promotional use: up to 12 months from first publication, then remove unless fresh permission is given. Permission evidence: keep during use and up to 24 months after last use, subject to a justified dispute/legal hold. Restricted storage location, authorised editor and scheduled deletion dates must be recorded privately before filming.

[ ] I have read the specific filming plan, selected my choices myself and freely give permission only for those choices.
Participant signature/written confirmation and date:
Final-edit approval reference and date (required before publication):
Operator name and verification date:

OPERATOR CHECK: retain one private permission record; confirm the person is an adult; provide a copy; keep footage restricted; diary the review/deletion dates; record withdrawal and removal. If permission is absent or uncertain, exclude/blur the person and remove identifiable voice/name, or do not publish. This form does not itself establish permission until the participant actively completes it.