PARTICIPANT RELEASE FORM

FOR STUDENT VIDEO & FILM PRODUCTION

Programme Title

(working or provisional):

Norwich For Teenagers

Name/s of producer/s: Ben Hagger

This section to be completed & signed by interviewee/participant:

Name:EMELYE COUZENS (print) I agree to participate in the production named above. The nature and composition of the programme have been explained to me and I hearby give my consent for the voice and/or picture recordings made of me, and my contribution, to be edited and used at the discretion of the Producers. Signed: E. Couzens Contact Address: For personal details, ask to see the official Participant Release Forms. Telephone: Date: Thursday 7th March 2013

PARTICIPANT RELEASE FORM

FOR STUDENT VIDEO & FILM PRODUCTION

Programme Title

(working or provisional):

Norwich For Teenagers

Name/s of producer/s: Ben Hagger

This section to be completed & signed by interviewee/participant:

Name:EMMA BATES (print) I agree to participate in the production named above. The nature and composition of the programme have been explained to me and I hearby give my consent for the voice and/or picture recordings made of me, and my contribution, to be edited and used at the discretion of the Producers. Signed: E. Bates Contact Address: For personal details, ask to see the official Participant Release Forms. Telephone: Date: Thursday 7th March 2013

PARTICIPANT RELEASE FORM

FOR STUDENT VIDEO & FILM PRODUCTION

Programme Title

(working or provisional):

Norwich For Teenagers

Name/s of producer/s: Ben Hagger

This section to be completed & signed by interviewee/participant:

Name: RYAN MUSTARD (print) I agree to participate in the production named above. The nature and composition of the programme have been explained to me and I hearby give my consent for the voice and/or picture recordings made of me, and my contribution, to be edited and used at the discretion of the Producers. Signed: R. Mustard Contact Address: For personal details, ask to see the official Participant Release Forms. Telephone: Date: Thursday 7th March 2013