Created
June 22, 2018 11:11
-
-
Save chrissyhroberts/e237e0b99cee6fa45a30b49a641411e1 to your computer and use it in GitHub Desktop.
Consent form for use of media files (LSHTM Format) 2018-06-22 | Change public key to your own at base64RsaPublicKey= before use
This file contains bidirectional Unicode text that may be interpreted or compiled differently than what appears below. To review, open the file in an editor that reveals hidden Unicode characters.
Learn more about bidirectional Unicode characters
| <?xml version="1.0"?><h:html xmlns="http://www.w3.org/2002/xforms" xmlns:ev="http://www.w3.org/2001/xml-events" xmlns:h="http://www.w3.org/1999/xhtml" xmlns:jr="http://openrosa.org/javarosa" xmlns:odk="http://www.opendatakit.org/xforms" xmlns:orx="http://openrosa.org/xforms" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><h:head><h:title>media_file_consent</h:title><model><submission base64RsaPublicKey="MIIBIjANBgkqhkiG9w0BAQEFAAOCAQ8AMIIBCgKCAQEA1DXk7dbAI89DscB5M+aBlbvtIUcelkwdYX+CBV9uHdvkCm6g0CJM0nrzjRrhKyty0hSgIRfhIBozIfEJYSwRusz/ClGeNiL8Fz3JGYfnFWLw4ZmNKQwAz2CS/zoI4Mu7QRjmeWPIBohdjHo1hJNIjogme0Iip4GDn+3DgsuvFYXxjkWlXN7opEkxAeBQukQzAxCiWbwdhKWKQzwgzmSu5HqCldkkQQ1Q5Zd/KsdmejWQa/5xDd/gOJ0ql+AVzZC1Z9fE0+2HLEEQca8pgWUPXAnPEK2BdNI/ltfPhgKOCE1inXAZxIrDSybePUIyYbIj14aQ30osMpp4EMFFU1rYbQIDAQAB" method="form-data-post"/><instance><Media_File_Consent_LSHTM id="media_file_consent"><add_file/><add_link/><resource_and_attribution><subject/><attribution_name/><attribution_entity/><attribution_date>today()</attribution_date></resource_and_attribution><number_consenting/><consent01><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent01><consent02><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent02><consent03><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent03><consent04><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent04><consent05><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent05><consent06><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent06><consent07><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent07><consent08><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent08><consent09><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent09><consent10><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent10><consent11><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent11><consent12><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent12><consent13><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent13><consent14><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent14><consent15><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent15><consent16><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent16><consent17><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent17><consent18><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent18><consent19><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent19><consent20><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent20><consent21><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent21><consent22><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent22><consent23><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent23><consent24><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent24><consent25><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent25><consent26><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent26><consent27><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent27><consent28><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent28><consent29><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent29><consent30><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent30><consent31><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent31><consent32><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent32><consent33><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent33><consent34><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent34><consent35><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent35><consent36><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent36><consent37><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent37><consent38><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent38><consent39><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent39><consent40><Consent/><name/><date_of_birth>2010-06-15</date_of_birth><image/></consent40><meta><instanceID/></meta></Media_File_Consent_LSHTM></instance><bind nodeset="/Media_File_Consent_LSHTM/add_file" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/add_link" type="string"/><bind nodeset="/Media_File_Consent_LSHTM/resource_and_attribution/subject" type="string"/><bind nodeset="/Media_File_Consent_LSHTM/resource_and_attribution/attribution_name" type="string"/><bind nodeset="/Media_File_Consent_LSHTM/resource_and_attribution/attribution_entity" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/resource_and_attribution/attribution_date" type="date"/><bind constraint=".<41" nodeset="/Media_File_Consent_LSHTM/number_consenting" type="int"/><bind nodeset="/Media_File_Consent_LSHTM/consent01" relevant=" /Media_File_Consent_LSHTM/number_consenting > 0"/><bind nodeset="/Media_File_Consent_LSHTM/consent01/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent01/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent01/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent01/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent02" relevant=" /Media_File_Consent_LSHTM/number_consenting > 1"/><bind nodeset="/Media_File_Consent_LSHTM/consent02/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent02/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent02/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent02/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent03" relevant=" /Media_File_Consent_LSHTM/number_consenting > 2"/><bind nodeset="/Media_File_Consent_LSHTM/consent03/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent03/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent03/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent03/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent04" relevant=" /Media_File_Consent_LSHTM/number_consenting > 3"/><bind nodeset="/Media_File_Consent_LSHTM/consent04/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent04/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent04/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent04/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent05" relevant=" /Media_File_Consent_LSHTM/number_consenting > 4"/><bind nodeset="/Media_File_Consent_LSHTM/consent05/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent05/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent05/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent05/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent06" relevant=" /Media_File_Consent_LSHTM/number_consenting > 5"/><bind nodeset="/Media_File_Consent_LSHTM/consent06/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent06/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent06/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent06/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent07" relevant=" /Media_File_Consent_LSHTM/number_consenting > 6"/><bind nodeset="/Media_File_Consent_LSHTM/consent07/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent07/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent07/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent07/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent08" relevant=" /Media_File_Consent_LSHTM/number_consenting > 7"/><bind nodeset="/Media_File_Consent_LSHTM/consent08/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent08/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent08/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent08/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent09" relevant=" /Media_File_Consent_LSHTM/number_consenting > 8"/><bind nodeset="/Media_File_Consent_LSHTM/consent09/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent09/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent09/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent09/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent10" relevant=" /Media_File_Consent_LSHTM/number_consenting > 9"/><bind nodeset="/Media_File_Consent_LSHTM/consent10/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent10/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent10/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent10/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent11" relevant=" /Media_File_Consent_LSHTM/number_consenting > 10"/><bind nodeset="/Media_File_Consent_LSHTM/consent11/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent11/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent11/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent11/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent12" relevant=" /Media_File_Consent_LSHTM/number_consenting > 11"/><bind nodeset="/Media_File_Consent_LSHTM/consent12/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent12/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent12/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent12/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent13" relevant=" /Media_File_Consent_LSHTM/number_consenting > 12"/><bind nodeset="/Media_File_Consent_LSHTM/consent13/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent13/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent13/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent13/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent14" relevant=" /Media_File_Consent_LSHTM/number_consenting > 13"/><bind nodeset="/Media_File_Consent_LSHTM/consent14/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent14/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent14/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent14/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent15" relevant=" /Media_File_Consent_LSHTM/number_consenting > 14"/><bind nodeset="/Media_File_Consent_LSHTM/consent15/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent15/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent15/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent15/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent16" relevant=" /Media_File_Consent_LSHTM/number_consenting > 15"/><bind nodeset="/Media_File_Consent_LSHTM/consent16/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent16/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent16/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent16/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent17" relevant=" /Media_File_Consent_LSHTM/number_consenting > 16"/><bind nodeset="/Media_File_Consent_LSHTM/consent17/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent17/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent17/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent17/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent18" relevant=" /Media_File_Consent_LSHTM/number_consenting > 17"/><bind nodeset="/Media_File_Consent_LSHTM/consent18/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent18/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent18/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent18/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent19" relevant=" /Media_File_Consent_LSHTM/number_consenting > 18"/><bind nodeset="/Media_File_Consent_LSHTM/consent19/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent19/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent19/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent19/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent20" relevant=" /Media_File_Consent_LSHTM/number_consenting > 19"/><bind nodeset="/Media_File_Consent_LSHTM/consent20/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent20/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent20/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent20/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent21" relevant=" /Media_File_Consent_LSHTM/number_consenting > 20"/><bind nodeset="/Media_File_Consent_LSHTM/consent21/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent21/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent21/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent21/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent22" relevant=" /Media_File_Consent_LSHTM/number_consenting > 21"/><bind nodeset="/Media_File_Consent_LSHTM/consent22/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent22/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent22/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent22/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent23" relevant=" /Media_File_Consent_LSHTM/number_consenting > 22"/><bind nodeset="/Media_File_Consent_LSHTM/consent23/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent23/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent23/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent23/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent24" relevant=" /Media_File_Consent_LSHTM/number_consenting > 23"/><bind nodeset="/Media_File_Consent_LSHTM/consent24/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent24/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent24/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent24/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent25" relevant=" /Media_File_Consent_LSHTM/number_consenting > 24"/><bind nodeset="/Media_File_Consent_LSHTM/consent25/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent25/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent25/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent25/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent26" relevant=" /Media_File_Consent_LSHTM/number_consenting > 25"/><bind nodeset="/Media_File_Consent_LSHTM/consent26/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent26/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent26/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent26/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent27" relevant=" /Media_File_Consent_LSHTM/number_consenting > 26"/><bind nodeset="/Media_File_Consent_LSHTM/consent27/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent27/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent27/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent27/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent28" relevant=" /Media_File_Consent_LSHTM/number_consenting > 27"/><bind nodeset="/Media_File_Consent_LSHTM/consent28/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent28/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent28/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent28/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent29" relevant=" /Media_File_Consent_LSHTM/number_consenting > 28"/><bind nodeset="/Media_File_Consent_LSHTM/consent29/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent29/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent29/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent29/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent30" relevant=" /Media_File_Consent_LSHTM/number_consenting > 29"/><bind nodeset="/Media_File_Consent_LSHTM/consent30/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent30/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent30/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent30/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent31" relevant=" /Media_File_Consent_LSHTM/number_consenting > 30"/><bind nodeset="/Media_File_Consent_LSHTM/consent31/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent31/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent31/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent31/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent32" relevant=" /Media_File_Consent_LSHTM/number_consenting > 31"/><bind nodeset="/Media_File_Consent_LSHTM/consent32/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent32/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent32/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent32/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent33" relevant=" /Media_File_Consent_LSHTM/number_consenting > 32"/><bind nodeset="/Media_File_Consent_LSHTM/consent33/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent33/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent33/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent33/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent34" relevant=" /Media_File_Consent_LSHTM/number_consenting > 33"/><bind nodeset="/Media_File_Consent_LSHTM/consent34/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent34/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent34/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent34/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent35" relevant=" /Media_File_Consent_LSHTM/number_consenting > 34"/><bind nodeset="/Media_File_Consent_LSHTM/consent35/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent35/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent35/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent35/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent36" relevant=" /Media_File_Consent_LSHTM/number_consenting > 35"/><bind nodeset="/Media_File_Consent_LSHTM/consent36/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent36/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent36/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent36/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent37" relevant=" /Media_File_Consent_LSHTM/number_consenting > 36"/><bind nodeset="/Media_File_Consent_LSHTM/consent37/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent37/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent37/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent37/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent38" relevant=" /Media_File_Consent_LSHTM/number_consenting > 37"/><bind nodeset="/Media_File_Consent_LSHTM/consent38/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent38/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent38/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent38/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent39" relevant=" /Media_File_Consent_LSHTM/number_consenting > 38"/><bind nodeset="/Media_File_Consent_LSHTM/consent39/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent39/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent39/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent39/image" type="binary"/><bind nodeset="/Media_File_Consent_LSHTM/consent40" relevant=" /Media_File_Consent_LSHTM/number_consenting > 39"/><bind nodeset="/Media_File_Consent_LSHTM/consent40/Consent" type="select1"/><bind nodeset="/Media_File_Consent_LSHTM/consent40/name" type="string"/><bind constraint=". <= today()" nodeset="/Media_File_Consent_LSHTM/consent40/date_of_birth" type="date"/><bind nodeset="/Media_File_Consent_LSHTM/consent40/image" type="binary"/><bind calculate="concat('uuid:', uuid())" nodeset="/Media_File_Consent_LSHTM/meta/instanceID" readonly="true()" type="string"/></model></h:head><h:body><upload mediatype="text/plain,application/pdf,application/vnd.ms-excel,application/msword,text/richtext,application/vnd.openxmlformats-officedocument.wordprocessingml.document,application/vnd.openxmlformats-officedocument.spreadsheetml.sheet,application/zip,application/x-zip,application/x-zip-compressed" ref="/Media_File_Consent_LSHTM/add_file"><label>Add a file here</label></upload><input ref="/Media_File_Consent_LSHTM/add_link"><label>Add a link/URL/Citation or similar</label></input><group ref="/Media_File_Consent_LSHTM/resource_and_attribution"><label>Resource and Attribution</label><input ref="/Media_File_Consent_LSHTM/resource_and_attribution/subject"><label>Describe the resource</label><hint>[i.e. "photo of fieldworker sampling from a river in Botswana"]</hint></input><input ref="/Media_File_Consent_LSHTM/resource_and_attribution/attribution_name"><label>Who needs to be attributed (name)</label><hint>[i.e. Alphonso Attitwa]</hint></input><input ref="/Media_File_Consent_LSHTM/resource_and_attribution/attribution_entity"><label>Who needs to be attributed (entity)?</label><hint>[i.e. @WHOAFRO, LSHTM]</hint></input><input ref="/Media_File_Consent_LSHTM/resource_and_attribution/attribution_date"><label>What is the attribution date?</label></input></group><input ref="/Media_File_Consent_LSHTM/number_consenting"><label>How many people need to give consent for this picture to be used</label><hint>(0-40)</hint></input><group ref="/Media_File_Consent_LSHTM/consent01"><label>consent01</label><select1 ref="/Media_File_Consent_LSHTM/consent01/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent01/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent01/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent01/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent02"><label>consent02</label><select1 ref="/Media_File_Consent_LSHTM/consent02/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent02/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent02/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent02/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent03"><label>consent03</label><select1 ref="/Media_File_Consent_LSHTM/consent03/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent03/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent03/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent03/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent04"><label>consent04</label><select1 ref="/Media_File_Consent_LSHTM/consent04/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent04/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent04/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent04/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent05"><label>consent05</label><select1 ref="/Media_File_Consent_LSHTM/consent05/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent05/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent05/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent05/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent06"><label>consent06</label><select1 ref="/Media_File_Consent_LSHTM/consent06/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent06/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent06/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent06/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent07"><label>consent07</label><select1 ref="/Media_File_Consent_LSHTM/consent07/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent07/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent07/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent07/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent08"><label>consent08</label><select1 ref="/Media_File_Consent_LSHTM/consent08/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent08/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent08/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent08/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent09"><label>consent09</label><select1 ref="/Media_File_Consent_LSHTM/consent09/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent09/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent09/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent09/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent10"><label>consent10</label><select1 ref="/Media_File_Consent_LSHTM/consent10/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent10/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent10/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent10/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent11"><label>consent11</label><select1 ref="/Media_File_Consent_LSHTM/consent11/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent11/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent11/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent11/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent12"><label>consent12</label><select1 ref="/Media_File_Consent_LSHTM/consent12/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent12/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent12/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent12/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent13"><label>consent13</label><select1 ref="/Media_File_Consent_LSHTM/consent13/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent13/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent13/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent13/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent14"><label>consent14</label><select1 ref="/Media_File_Consent_LSHTM/consent14/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent14/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent14/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent14/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent15"><label>Consent #1</label><select1 ref="/Media_File_Consent_LSHTM/consent15/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent15/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent15/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent15/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent16"><label>consent16</label><select1 ref="/Media_File_Consent_LSHTM/consent16/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent16/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent16/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent16/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent17"><label>Consent #1</label><select1 ref="/Media_File_Consent_LSHTM/consent17/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent17/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent17/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent17/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent18"><label>consent18</label><select1 ref="/Media_File_Consent_LSHTM/consent18/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent18/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent18/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent18/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent19"><label>consent19</label><select1 ref="/Media_File_Consent_LSHTM/consent19/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent19/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent19/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent19/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent20"><label>consent20</label><select1 ref="/Media_File_Consent_LSHTM/consent20/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent20/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent20/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent20/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent21"><label>consent21</label><select1 ref="/Media_File_Consent_LSHTM/consent21/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent21/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent21/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent21/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent22"><label>consent22</label><select1 ref="/Media_File_Consent_LSHTM/consent22/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent22/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent22/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent22/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent23"><label>consent23</label><select1 ref="/Media_File_Consent_LSHTM/consent23/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent23/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent23/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent23/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent24"><label>consent24</label><select1 ref="/Media_File_Consent_LSHTM/consent24/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent24/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent24/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent24/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent25"><label>consent25</label><select1 ref="/Media_File_Consent_LSHTM/consent25/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent25/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent25/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent25/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent26"><label>consent26</label><select1 ref="/Media_File_Consent_LSHTM/consent26/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent26/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent26/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent26/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent27"><label>consent27</label><select1 ref="/Media_File_Consent_LSHTM/consent27/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent27/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent27/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent27/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent28"><label>consent28</label><select1 ref="/Media_File_Consent_LSHTM/consent28/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent28/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent28/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent28/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent29"><label>consent29</label><select1 ref="/Media_File_Consent_LSHTM/consent29/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent29/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent29/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent29/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent30"><label>consent30</label><select1 ref="/Media_File_Consent_LSHTM/consent30/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent30/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent30/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent30/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent31"><label>consent31</label><select1 ref="/Media_File_Consent_LSHTM/consent31/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent31/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent31/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent31/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent32"><label>consent32</label><select1 ref="/Media_File_Consent_LSHTM/consent32/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent32/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent32/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent32/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent33"><label>consent33</label><select1 ref="/Media_File_Consent_LSHTM/consent33/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent33/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent33/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent33/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent34"><label>consent34</label><select1 ref="/Media_File_Consent_LSHTM/consent34/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent34/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent34/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent34/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent35"><label>consent35</label><select1 ref="/Media_File_Consent_LSHTM/consent35/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent35/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent35/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent35/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent36"><label>consent36</label><select1 ref="/Media_File_Consent_LSHTM/consent36/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent36/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent36/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent36/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent37"><label>consent37</label><select1 ref="/Media_File_Consent_LSHTM/consent37/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent37/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent37/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent37/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent38"><label>consent38</label><select1 ref="/Media_File_Consent_LSHTM/consent38/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent38/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent38/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent38/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent39"><label>consent39</label><select1 ref="/Media_File_Consent_LSHTM/consent39/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent39/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent39/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent39/image"><label>signature</label></upload></group><group ref="/Media_File_Consent_LSHTM/consent40"><label>consent40</label><select1 ref="/Media_File_Consent_LSHTM/consent40/Consent"><label>I hereby consent that the London School of Hygiene & Tropical Medicine shall have the right to copyright, publish or use any photographs, video-recordings or other electronic media and/or sound recordings, or any part thereof, they have taken or made of me this date or in which I may be included, for publicity, advertising or any other lawful purpose in conjunction with my own or a fictitious name, or in reproductions thereof in colour or otherwise in perpetuity. | |
| I hereby waive all claims for any compensation for such use and hereby release the London School of Hygiene & Tropical Medicine from all liabilities or claims that I could assert in connection with the above described uses. | |
| I hereby waive any right that I may have to inspect and/or approve the finished product or the use to which it may be applied. | |
| I hereby warrant that I have every right to contract in my own name in the above regard. I state further that I have read the above authorisation and release, prior to its execution, and that I am fully familiar with and understand the above terms.</label><item><label>Yes</label><value>Yes</value></item><item><label>No</label><value>No</value></item></select1><input ref="/Media_File_Consent_LSHTM/consent40/name"><label>Enter Your Name</label></input><input ref="/Media_File_Consent_LSHTM/consent40/date_of_birth"><label>Enter your date of birth</label><hint>This field has a constraint and default value</hint></input><upload appearance="Signature" mediatype="image/*" ref="/Media_File_Consent_LSHTM/consent40/image"><label>signature</label></upload></group></h:body></h:html> |
Sign up for free
to join this conversation on GitHub.
Already have an account?
Sign in to comment