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Consent Form

I agree that:

 I am free to film on the ………..

 Film may be submitted into competitions
 Footage can be edited
 Footage can be kept after used
 Any footage I receive won’t be uploaded or distributed without ‘Thomas Ostridge’s’ consent
 Footage including me can be shared publicly and published under the name of Henley College.
(To their YouTube channel etc...)

I would like to receive copy of footage that I am in

I would like to receive a copy of final edited production

Phone: ___________________________________________

Email: ____________________________________

Sign: ____________________________________

Print: ____________________________________

Date: ____________________________________