KIRKBY STEPHEN GRAMMAR SCHOOL AND COMMUNITY CENTRE

A learning community committed to success for all.

Kirkby Stephen, Cumbria CA17 4HA. Telephone (017683) 71693 Fax (017683) 72387 E-mail: ksgsoffice@aol.com

Dear Parent/Guardian of Jessica Daldry,

Jessica has been asked to play a character within my A Level Media music video and as she is under the age of 18, parental permission is needed for her to be able to take part. Just to make you aware, this music video may be put on the internet for coursework reasons, so others may be able to access it. If you have any other questions please ask me and I will answer them for you.

Yours Sincerely, Natasha Daldry

If you give your permission for your daughter to take part, please sign below and hand it in to me as soon as possible.

I give/dont give my permission for my daughter Jessica Daldry to take part in an A Level media project to play a character for a music video.

Parents/Guardians signature..

Headteacher: Mr David Keetley BA MEd NPQH Deputy Headteacher: Mr Raw

Schools Curriculum Award 1992 and 2000