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Informed consent to the publication of pictures/movies

(please complete, sign, and give the teacher)

The team OLPC / Ondalivre, promotes internet in public schools in developing countries,
make an online manual (X-LC1) in the context of this opensource project. Because children
can be seen in the movie will require the consent of the mother, father or parent's person.

We only publish sequences that have agreed all parents/guardians of involved children.

I give my consent, that the film contribution, on which my child

________________________________ (first name, last name) is seen, can


be published.

Place, date Signature

______________________________ _________________________________

Link
Project http://sourceforge.net/projects/xlc1
Storyboard http://create.ly/g42ga3821 (for X-LC1 online manual)
Forum http://www.olpc-forum.org
Support Switzerland http://x-event.designo.ch
h t t p : / / x- e ve n t . d e s i g n o . c h / e n / f i l e / In f o r m e d C o n s e n t - e n . p d f
Confirmation of teacher

I certify that I have received the consent of all parents or guardians (signature) whose
children seen on film (online manual X-LC1).

First name ______________________________________________

Last name ______________________________________________

Address, City ______________________________________________

______________________________________________

______________________________________________

School ______________________________________________

Function ______________________________________________

Place, date Signature

______________________________ _________________________________

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