Youth Film Project Consent Form 📽️🎬

Youth Film Project Consent Form 📽️🎬

Youth film project – In This Together. Please complete this form if you are the Youth film project – In This Together. Please complete this form if you are the parent/guardian of a participant under 18. Contact the project manager, Afzaal Hussain, at inthistogether.bucks.campaign@gmail.com or 07935 84491
Participant Information
Participant full name

First NameLast Name
Date of birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Carer Information
Parent/Carer Full Name

First NameLast Name
Mobile Number for Parent/Carer

Area CodePhone Number
Relationship to Participant
Address
Mobile Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Consent and Permissions
Mobile Number for young person
I confirm that I am the parent/carer with legal responsibility for the above-named young person. (As stated in the source document, repeated statement.)
I give permission for my child to take part in the Youth Film Project from 28th–30th May.
I understand that my child may be filmed and recorded (video and audio).
I give permission for my child’s image and voice to be used in the final film.
I understand that once the film has been published, it may not be possible to fully withdraw or remove footage.
I understand that participation is voluntary and that my child may withdraw from activities at any time before filming is completed.
Emergency Contact
Emergency Contact Name
I give permission for my child to take part in the Youth Film Project.
Please enter a valid phone number.Format: (000) 000-0000.
Final Declaration and Signature
Confirmation of Accuracy and Understanding
Name of Parent/Carer
Date

MonthDayYear
Date
Parent/carer Signature
Should be Empty:

Youth Film Project Consent Form 📽️🎬

Participant Information

Parent/Carer Information

Consent and Permissions

Emergency Contact

Final Declaration and Signature