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Consent form for household owner
1. Consent Form for Household Owner
I give permissionforboththe interiorandexteriorof myhouse to be filmedbyKatie Halfyard,Lucy
Clarke,HamzaHanif and Eman Shah fortheirA2 MediaStudiesCourseworkwhichinvolvesthem
creatinga short film.Iunderstandthatthisshortfilmwill be putontoYouTube,meaningthatpeople
I do notknowmay see it,alongwiththe examinerandSimonAske (TitusSalt’sMediaStudies
teacher).Iam aware that I can withdraw mypermissionandask foranythingalreadyfilmednotto
be used,up until the 1st
March 2016. However,IunderstandthatafterthispointI will notbe able to
withdrawfromthe processas itwill be tooshort notice forthe productionteam.
Name (printed):
Signature:
Date: