Harrow College Media

Permissions of access to location form

With reference to the following production: Rum and Redbull Music Video Produced by: Irfaat Nurudin, Marcia Preciosa, Courtney Lang and Jason Pregal In consideration of the request for audio / video recording as follows: Location: Brookshill Cemetery Date: 22.11.11 Time: 11.00am – 4.00pm

Please tick / fill in as applicable:

Permission is given Permission cannot be given × Permission is given subject to the following conditions:

No shooting the gravestones names

Don’t disturb the mourners

Don’t cause disorder of the gravestones

Name (Please print): Marcia Preciosa Date: 22.11.11 Position: Cameraperson

Address: Brookshill

Harrow Weald, Middlesex HA3 6RR

Contact telephone number:07919383412

Harrow College Media

Actor / Contributor Consent form

With reference to the following production: Rum and Redbull Music Video Produced by: Courtney Lang

In consideration of the non-remuneration agreement between myself and Harrow College Media I consent to the performance / interview / contribution given by me to be used in the above production. This agreement also allows ‘unlimited’ future copying / broadcasting of the said material without payment. This agreement also allows Harrow College Media and the above named producer / production company to exhibit / exploit the performance / interview / contribution in any contemporary or future audio-visual media throughout the territories of the United Kingdom and the rest of the World. Names (Please print): David Williams Nelissa Rose Irfaat Nurudin Date: 12.12.11 Esther Parkinson Jason Pregal Courtney Lang Address (Please print): Brookshill, Harrow Weald, Middlesex HA3 6RR Contact telephone number: 07946533808