Chipstead Place Lawn Tennis Club
CPF 3.1.7 - Consent form – photography and filming
I give permission for me/my child _____________________________________________
to be involved in any publicity (including photographs/TV footage) surrounding the following event/publication:__________________________________________________
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Signed |
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Date |
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Name (please print) |
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Relationship to child |
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Address |
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Full details of parent/carer/guardian if additional or different from above:
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Name (please print) |
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Address |
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Contact numbers |
Mobile |
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Home |
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Work |
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Email address |
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Please return this form to:
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Name (please print) |
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Address |
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