Permission to film

I would like to inform you that in the upcoming 3-4 weeks, we will be filming a short music video for our media coursework. We will be including you child (ren). This music video will take place in various locations around London. We would like to be granted permission to use footage of your child (ren). If you would like your child (ren) to participate, please answer the following questions:

Child’s Full Name…………………………………………………………………

Gender:              Male                                Female

Does your child have any allergies? (If yes please state)……………………………………………………

Does your child have any medical conditions? (If yes please state)……………………………………………………

Parents Full Name………………………………………………………..

Date………………………………………………….