The model release form gives permission to students at Harris Dulwich Boys' to use the name and photographic likeness of Carlo-Gino Tenkorang in all forms of media, including television and print advertising. It requests contact information like name, address, postcode, mobile number and email from Carlo-Gino Tenkorang. The form must be signed and dated by Carlo-Gino Tenkorang to be valid.

1. Carlo-Gino Tenkorang
Model Release Form
I hereby give permission to the students of Harris Dulwich Boys’ to
use my name and photographic likeness in all forms and media for
the making of the TV and Print Advert.
Name:
Address:
Postcode:
Mobile:
Email:
Signature:
Date: