Title of Production: Name of Project Leader: Your Name: Your E-Mail Address: Your Contact Phone Number: (Only if Under 18) Parent's Name: (Only if Under 18) Parent's Email Address: (Only if Under 18) Parents Contact Phone Number: By Ticking this Box, I Hereby affirm that my appearance/performance in the above mentioned college/student production took place with my full consent freely given. I give to Highlands College in perpetuity all rights to use the said appearance/performance, and I release Highlands College from any liability to me in respect of the said appearance/performance. Please Sign in the Box Below: (If using a tablet or phone with your hand. If using a computer, please use your mouse) (If you are under 18) Parent, Please Sign in the Box Below: (If using a tablet or phone with your hand. If using a computer, please use your mouse)