Parent Name *

First Name

Last Name

Student Name *

First Name

Last Name

I give The Rhythm Studio / The Rhythm Studio Foundation* permission to use any still and/or moving image being video footage, photographs and/or frames and/or audio footage depicting my/our child/ren named above taken who participate in The Rhythm Studio Foundation music workshops and performances. These will only be used to support the work of The Rhythm Studio/The Rhythm Studio Foundation in an appropriate context and may include (but is not limited to) website, television, radio, print media and other publications such as information leaflets, annual reviews, training and educational materials. *

Yes

No