Parent or Carers Name *

First Name

Last Name

Participant In The Show *

First Name

Last Name

Electronic Signature *

I agree to (please tick) my child being filmed during the activity. I understand that Swanland Media can see no risk presently, and that I take full responsibility for my involvement in this project and the risks that it may entail (be they legal, physical, or mental) and release Swanland Media from any claims, demands, losses, damages, suits, and liabilities of any kind whatsoever in connection with the foregoing distribution of this film.

I Agree