A student named Charlie Hall is creating a documentary film for his media diploma and is asking Raymond Moonie to sign a consent form agreeing to be filmed for the project. The consent form states that Raymond understands his participation is voluntary, he can choose not to participate or withdraw at any time, and he gives Charlie permission to film him for use in the media diploma project.
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Consent form
1. Consent Form:
My name is Charlie Hall and I am a Media Diploma Student at
Long Road Sixth Form College. I am creating a documentary film
and would like to film you for this. Therefore I would like you to
sign this consent form.
I Raymond Moonie agree to take part in the Diploma project stated
above. I have had the project and process explained to me and I
understand that agreeing to participate means I am willing to:
I understand that my participation is voluntary; that I can choose
not to participate in part or all of the project, and that I can
withdraw at any stage.
I give permission to be filmed by Charlie Hall for the use of a
Media Diploma project.
Name: Raymond Moonie
Signed:
Date: