1. Model Release Form
Full Name: MortThanomsap
Address:
Nene Park Academy
Oundle Road
Peterborough
PE2 7EA
Telephone Number: 07943267901
Shoot Location: Nene Park Academy – TV Studio
Date: 29/11/2014
I hereby give Arthur Tumbare , the irrevocable and unrestricted right to use and publish
video footage or photographs of me that are taken on the above date. These may be used
for educational purposes (that may include publishing to a public video forum, such as
YouTube or a blog), film production or advertising.
Print Name: Mort Thanomsap
Signature:
