1. Company: Amethyst Productions Production: From Outside In To be returnedto:Lucy Pratt
Permission Slip
Amethyst Productions has permission to use my son/ daughter as an actor in the film of
‘From Outside In’. I am aware that __________________ will be speaking/ not speaking
within the film and that this film will become public on either YouTube or Short of the
Week. _________________ agrees to take on the role of ______________________ and
knows of the previously stated location of the final film. I am aware that the film will be
used for/ is being made as a part of Lucy Pratt’s final project in her OCR Level 3 Media
Studies course. I understand that my son / daughter with Lucy Pratt have confirmed the
location, dates and times of the shoots and I have been informed of this.
______________________________ ______________________________
Parent/ Guardian’s name child’s name
______________________________ ______________________________
Parent/ Guardian’s signature child’s (over 16) signature
____________________
Date
