[Your Details]
[Image Details]
I declare:
I understand that if the declaration is false I will be liable for infringements of copyright.
Data Protection Act 1998:
I confirm that these photographs are for use with my personal research only and that any images that are Personal Data, as defined by the act will be stored securely and not disclosed to unauthorised third parties.
Signature
Date:
This must be the personal signature of the persons making the request. A stamped or typed written signature, or signatures of an agent, is not acceptable.