FOOTAGE LICENSE

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					CONSENT/ RELEASE FORM
University of Greenwich, School of Computing & Mathematical Sciences, Old Naval
College, Park Row, Greenwich SE10


We are a group of undergraduate Film/TV Production students who have to produce a short
film/television programme as part of our coursework.
The programme we are currently working on is about ………………………………….........

………………………………………………………………………………………………………..

With your consent we would like to you to be involved. Below is a brief description of what we
would like to film and how you will be involved and a rough indication of the time involved:




The material will be used as part of our coursework ONLY. The material will not be copied or
viewed outside the university, nor will it be used in a derogatory way.

Production/Assignment description:………………………………………………………………

Name of participant:

Contact Number (if agreeable)



Date:


PROJECT TITLE: ………………………………………………………………………

I (the undersigned) do hereby confirm that I have agreed to be filmed and photographed in
connection with the production ……………………………………………………. on
the………………………. (date), the nature of which has been explained to me.


I hereby grant to you, your successors, assigns and licensees, to use as you desire in any
manner or in any media currently existing or which may be developed in the future, all video,
still and motion pictures that you may take of me.


I understand that I shall receive no fee for my appearance in and participation in the film.
I am over 18 years of age.


Signed .............................................................................

I have no objections to the material being used for teaching purposes and associated
scholarly activities at the University of Greenwich.

Signed .............................................................................

If you have any queries, or would like to check the validity of the project please call: -
Val Brown on 020 8331 8654
COPY TO BE LEFT WITH PARTICIPANT
RTICIP ANT