PARTICIPANT RELEASE FORM

FOR STUDENT VIDEO and PHOTOGRAPHY PRODUCTION

Title (working or provisional):………UKN MAGAZINE PHOTOSHOOT…………………………………………………

Name/s of producer/s: ………Dylan O’Sullivan…………………………………….

This section to be completed & signed by interviewee/participant:

Name:…………………Oliver Tilley…………………………………….….(print)

I agree to participate in the production named above. The nature

and composition of the video/photoshoot have been explained to
me and I hereby give my consent for the voice and/or picture
recordings made of me, and my contribution, to be edited and used
at the discretion of the Producers. I acknowledge that by signing
this form I give up all claims of ownership, income, editorial control
and use of the resulting voice and/or picture recordings and assign
all copyright ownership to the Producer.

Signed: ………………………Ollie Tilley……………………………………………

Date: …………………15/11/20……………………………………………………………….