Parental Permission FormTilly Studios & Perfect Pitch Choirs Child's Name * First Name Last Name Child's D.O.B. * MM DD YYYY Gender * Male Female Other Prefer not to say Medical Information * Please provide details of any medical conditions, or medication taken on a regular basis. (e.g. Hayfever, asthma, diabetes etc.) - please type N/A if none. Parental Consent * Do you consent to Perfect Pitch and Tilly Studios team providing first aid treatment if required? (e.g. plaster, bandage etc.) Yes No Parent Name * First Name Last Name Parent Mobile Number * (###) ### #### Parent Email * Emergency Contact Name * First Name Last Name Emergency Contact Number * (###) ### #### Photographs & Media * Do you give permission for your child's image to be published on letters, posters and newsletters? Yes No * Do you give permission for your child's image to be uploaded on to the Perfect Pitch & Tilly Studios website? No child's full name will be disclosed under any circumstance. Yes No * Do you give permission for your child's image to be used across Perfect Pitch & Tilly Studios' SOCIAL MEDIA platforms? No child's full name will be disclosed under any circumstance. Yes No * Do you give permission for your child's image to be used by media publications? (e.g. press, TV, newspaper articles, magazines etc.) - no child's full name will be disclosed under any circumstance. Yes No * Do you give permission for your child to be photographed/filmed by Perfect Pitch and Tilly Studios. The images/videos may be purchased by and/or shared by other parents/guardians? (e.g. photos/performance DVDs) Yes No Thank you! Your response has been submitted.