KIRKBY STEPHEN GRAMMAR SCHOOL AND COMMUNITY CENTRE

A learning community committed to success for all.

Kirkby Stephen, Cumbria CA17 4 A! "elephone #017$%&' 71$9& (a) #017$%&' 72&%7 *+mail, ks-so..ice/aol!com

Consent for an under 18 to take part in a music video

Dear Parent/Guardian/Carer, I am currently a sixth form student studying level !edia" #hich includes me producing a music video in #hich I need students to play the characters$ I am #riting this letter to ask for permission for your son/daughter to participate in my music video$ %he footage #ill &e used &y my !edia teacher '!iss (e#stead), the examiner and myself$ I may need to upload the video to social media sites such as *ou%u&e to receive feed&ack to help #ith my evaluation$ I #ould &e very grateful if your son/daughter #ould &e a&le to participate$ *ours sincerely Gail +ennison

%o &e completed &y the Parent/Guardian/Carer (ame of student, ----------------------------------I do/do not give permission for my son/daughter to &e filmed/photographed .ignature, //////////

eadteacher, 0r 1a2id Keetley 3A 0*d 456 1eputy eadteacher, 0r 7aw

Schools Curriculum Award 1992 and 2000