Home › Production templates › Parent / guardian consent for a minor
Parent / guardian consent for a minor
Consent, contacts, health information and on-set conditions for anyone under 18 who takes part in a shoot.
Template for guidance only, not legal advice. Laws differ by country: check local law, and ideally a lawyer, before signing.
Details
| Minor (full name, date of birth) | |
|---|---|
| Parent / legal guardian (name, relationship, ID no.) | |
| Phone & email | |
| Emergency contact (name, phone) | |
| Allergies, medication, health notes | |
| Production company | |
| Project title | |
| Role | |
| Shoot dates and places | |
| Maximum hours on set per day / breaks | |
| Chaperone on set (name, phone) | |
| Fee (if any) and who receives it |
Consent
- As parent or legal guardian, I agree that the minor named above takes part in the project on the dates and conditions above.
- A parent, guardian or the named chaperone stays with the minor at all times on set. The minor is never left alone with an adult who is not the chaperone.
- The production respects the working hours, rest, schooling and permit rules for minors in the country of the shoot, and obtains any child work permit required: ___.
- No dangerous, frightening or inappropriate scenes without explaining them first and getting my written consent.
- The production may use the minor’s image and voice in the project and its promotion, in all media, worldwide, without time limit, unless limited here: ___.
- In an emergency, if I cannot be reached, the production may seek medical care for the minor and will inform me immediately.
Signatures
Parent / legal guardian
Name: ____________
Signature: ____________
Date: ____________
Minor (if old enough)
Name: ____________
Signature: ____________
Date: ____________
For the production
Name: ____________
Signature: ____________
Date: ____________
Generic template provided for convenience. It is not legal advice and may not suit your project or country: have it reviewed by a qualified lawyer before use.
Rolling Now · rollingnow.com · Updated 17 October 2026