Consent Form

I, ______________________________________________________ hereby grant

permission to Amy Antoniou, Katie Dent and Katerina Paraschou to
allow my son/daughter/myself to appear in your media production,
as part of our A2 Level work.
I understand that the product in which is being made will be shown
to a small audience for an A2 media production, which will be seen
by examiners and an audience at a school ceremony.

Full Name _______________________________________________________________

Signature ________________________________________________________________
Date ______________________________
D.O.B ____________________________