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
Storyboard
Forum
Support Switzerland

http://sourceforge.net/projects/xlc1
http://create.ly/g42ga3821 (for X-LC1 online manual)
http://www.olpc-forum.org
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

______________________________

_________________________________

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

Sign up to vote on this title
UsefulNot useful