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Acting Consent Agreement

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GUARDIAN


Name:
Sddress:
City:
State:

Zip:
Phone #:
E-Mail:

CHILD:

Name:
Address:
City:
State:

Zip:
Social Security #:
Gender:
Age:
DOB:

PERFORMANCE INFORMATION:


Production Name:
Name of Director/Producer:
Address:
City:
State:
Zip:

Is there an escort for the child?

CONSENT DATES:

Consent From:

To

Other Details

The date the document will be signed:
Add proof of service of this document?
How many witnesses would you like to add?

Would you like to add extra details?