A student is requesting permission to film other students for their A2 Media course project. The video will be uploaded to YouTube to be graded. Some risks were identified but minimized. Parents are asked to indicate if they consent to their child being filmed and named in the video or just filmed without being named.

1. 2013-2014
Media Permission Form
Dear Adult/Parent/Guardian
During the spring term I will be filming my A2 Media piece and I would like the permission to
film your child for use as my final piece. The final product of the video will be put on
YouTube to be marked and therefore the student will have to be comfortable with this.
Some risks have arisen however these have been highlighted on a risk assessment and
minimized to their greatest potential.
Please complete the section below and return the form to the school office.
If you are over 18 a parents/guardian signature is not applicable.
Thank you for your cooperation in helping us highlight the good work and efforts of our
learners and instructors.
Please check one:
 give permission for my child to be photographed and filmed and permission to have my
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child’s name used. Full names will be used on both film (credits) and description of video.
 give permission for my child to be photographed and filmed, but do not want my child’s
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name used or placed on a social networking site.
 do not want my child photographed or Filmed and do not want his or her name used or
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placed on a social networking site.
Many Thanks
Reuben Lax