Give a better life
to eczema-prone children.
Join Lipikar Families
LIPIKAR FAMILIES PARTICIPATION FORM
DECLARATIONS AND AUTORISATION
By participating in the Lipikar Families program, an entirely free program arranged by the company [TO FILL IN] from DD/MM/YYYY to DD/MM/YYYY inclusive.
I agree to
- Log on at least one (1) time a month to share my first-hand account with a post and a photo.
- Abide by the chat room rules [HYPERLINK].
Furthermore, I explicitly authorise the free reproduction, representation, modification, adaptation (translation in particular), transfer and distribution of my testimonials and/or photographs to promote or advertise the products and/or brands of Cosmétique Active International or of other companies belonging to its Group, notably in the following media: (i) the written press and magazines (ii) the Internet (regardless of the platform and/or format, including so-called "social network" sites such as Facebook, YouTube or Dailymotion), and (iii) any other advertising medium (particularly posters displayed at points of sale and on the products of Cosmétique Active International or of other companies belonging to its Group) (hereinafter referred to as the "Media").
This authorisation is granted free of charge and starting from the first publication of your testimonial and/or your photo via the platform, for the entire world, with no limitations on the number and, where applicable, by extension, and for any type of medium (audiovisual, written press, Internet, etc.) for a period of [TO BE DETERMINED] starting with the initial public release.
I declare explicitly that I own the rights to the testimonials and/or photographs that I submit to you.
In accordance with the provisions of laws governing the protection of personal data and privacy, you have the right to access, correct, contest and delete data that pertains to you. You can exercise this right at any time by sending an e-mail, accompanied by a photocopy of your identity papers or passport, to the following address: [MAILING ADDRESS AND/OR ELECTRONIC ADDRESS]
Persons who exercise their right to delete their data before the end of the programme shall be considered to have ended their participation.
The information gathered as part of the LIPIKAR FAMILIES Programme may be used to recruit new customers, provided you have given your prior consent by ticking the box included on the Programme registration form.
Finally, if you are among the winners, you authorise us from this moment, free of charge, to publish on the Platform your surname, given name and, possibly, your photo for a period of one year.
We have received your application and we thank you.
We will get back to you if you are selected to take part in the LIPIKAR Family Program.