Contributor Release Form
Full Name:
Jessica Moore
Address: 17 Hertfordshire
Road
Barnard
Castel
Telephone
Number: 07847574283
Shoot
Location: Media Studies Room
Date:
27/01/2014
I hereby
give Your Full Name , the
irrevocable and unrestricted right to use and publish video footage or
photographs of me that are taken on the above date. These may be used for educational
purposes (that may include publishing to a public video forum, such as YouTube
or a blog), film production or advertising.
Print Name: Jessica
Moore
Signature:
(Signed in person)
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