MEDIA RELEASE FORM

I ______________________ give permission to Bournemouth and Poole College

to use my/my child’s image and likeness in photographs and/or video for use in
Media publications and Promotion Material which include:
Tick all that apply:

- Social Media Posts - Website - Newsletters/Magazines

- General Publications - Other _________________________________

I am 18 years of age and fully understand the impact and meaning of this
release

I am the parent or legal guardian of the child named below.

Signature: __________________ Date: ______________

Print Name: __________________ Email Address: _________________

Signature of parent or legal guardian: __________________

Print Name : ___________________
(If under 18 years of age)