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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:__________________________________________________

 

 

Signed

 

 

Date

 

Name (please print)

 

 

Relationship to child

 

 

Address

 

 

 

 

 

 

 

Full details of parent/carer/guardian if additional or different from above:

 

Name (please print)

 

 

Address

 

 

 

 

 

Contact numbers

Mobile

 

 

Home

 

 

Work

 

 

Email address

 

 

 

Please return this form to:

 

Name (please print)

 

 

Address

 

 

 

 

 

 

 

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