PARTICIPANT RELEASE FORM
FOR STUDENT VIDEO & FILM PRODUCTION
Programme Title
(working or provisional): Advanced Portfolio A2 Music Video
Name/s of producer/s: Fraser White
This section to be completed & signed by interviewee/participant:
Name:..(print)
I agree to participate in the production named above. The nature
and composition of the programme have been explained to me and
I hereby give my consent for the voice and/or picture recordings
made of me, and my contribution, to be edited and used at the
discretion of the Producers.
Contact Address:Quayside Plaza, South Quay, Great Yarmouth,
Norfolk, NR30
2QH
Telephone:07557643106
Date:9/16/14