BACHELOR OF EDUCATION (Early Years)

PRIMARY SCHOOL - PERMISSION TO PHOTOGRAPH/VIDEO FORM

All primary schools require teachers to observe and document, interpret and analyse children’s learning, growth and
behaviour. Part of a successful placement for a pre-service teacher is to begin to develop and practise these skills in the
workplace.
We ask that the supervising teacher support the pre-service teacher in the development of their professional skills. This can
be done by helping the pre-service teacher gain permission from parents/guardians to undertake observations of children.
This may include taking photos/videos where appropriate and only in ways that do not breach the child’s right to privacy and
confidentiality. These observations/photos/videos will only be used to illustrate the pre-service teacher’s learning in specific
subjects at Melbourne Polytechnic. Annotated work samples may also be required which are copies of children’s work which
show evidence of feedback provided by the pre-service teacher. All data will be destroyed at the end of this semester.
PRE-SERVICE TEACHER

PRE-SERVICE TEACHER NAME

• I agree to select children for observation in consultation my supervising teacher.

• I will adhere to the school’s protocol and privacy policy procedures.
• I am aware of the need to maintain full confidentiality, privacy and respect for the child and family.
• I will omit any use of names from recorded information (de-identify all data).
• The recorded information is required for and will be used for the following subject:

SUBJECT NAME BEC418 Teacher Identities

PRE-SERVICE TEACHER SIGNATURE Date

SUPERVISING TEACHER
The pre-service teacher must discuss their proposed observation/photography/video with their supervising teacher
and receive signed approval before approaching parents and the child for permission.

Supervising teacher name

Supervising teacher signature Date

PARENT/GUARDIAN

I give permission for my child to be included in (please indicate your approval by ticking the box)
 photos/videos that do not breach our rights to privacy and confidentiality
 annotated work samples that do not breach our rights to privacy and confidentiality
I understand that these photographs and/or video recordings form part of the academic requirements of placement
at Melbourne Polytechnic and that my child's identity and right to confidentiality will be protected.
We also ask that you discuss the role of the pre-service teacher with your child. If your child is comfortable in
participating in this process then they can note their agreement below.

Parent/Guardian name
Parent/Guardian signature Date

CHILD
I give permission to be included in (please indicate your approval by ticking the box)
 photos/videos that do not breach our rights to privacy and confidentiality
 annotated work samples that do not breach our rights to privacy and confidentiality

Child’s name
Child’s signature Date