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Actors Release Form
Actors Release Form
Oaks Lane, Newbury Park, Ilford, Essex, Tel: 0208 590 3782
I hereby certify and represent that I am of legal age and have every right to contract in my own name in connection with this Release, and that I have read the foregoing and fully understand the meaning and effect thereof, and intending to be legally bound I have signed this Authorization this 13th day of October, 2011. Any actor who is under the age of 18 must have his or her legal guardian sign the release form. Date of Birth: 02/09/1993 18 Years of Age Print Name: MARIAM NAWAB Signature: Legal Guardian Name: KAUSAR NAWAB Legal Guardian Signature: Address: 50 Longbridge Road, Ilford, Essex Phone: 0205 573 2944 Email: oaksparkhighschool@hotmail.co.uk Date: 13/10/2011
Oaks Lane, Newbury Park, Ilford, Essex, Tel: 0208 590 3782