Consent Form

Dear Parent/Guardian

Your son/daughter has been selected to participate in my A2 media film “Heist” a non-profit film. The participation of your son/daughter is crucial to the creation of the film. Filming will start at the beginning of December 2013 and will finish early January 2014. Please fill in the details below to give permission to your son/daughter to take part in the film.

From Kristopher Cook A2 Level Media Student

Media Studies Film Consent Form

I parent/guardian of __________________ hereby permit/ do not permit my son/daughter to be part of A2 media film “Heist".

Signed:___________________________ Date:_______________________