STUDENT AND PARENT/GUARDIAN AUTHORISATION FOR USE OF STUDENT MATERIALS AND NAME IN WIDE OPEN CODE COMPETITION WHERE STUDENT IS UNDER 18 YEARS OF AGE I, ______________________________________ the parent / legal guardian of the Student and, I, ______________________________________ , the Student, agree to and provide permission for the use or reproduction of any materials, photographic, video, audio or any other form of electronic format, developed or provided by the Student in the course of the Wide Open Code Competition, by the Crown in Right of the State of Victoria (Department of Education and Training). I authorise the use or reproduction of any such materials for any reasonable purpose within the discretion of the Department of Education and Training without acknowledgment and without being entitled to remuneration or compensation. In particular, I authorise use of the materials for the purposes of promoting and showcasing the Wide Open Code Competition, such as by inclusion in a display at an expo, on the IT Career website located at http://www.sofweb.vic.edu.au/itcareer/index.htm or for use on a promotional CD Rom. I understand and agree that if I wish to withdraw this authorisation, it will be my responsibility to inform eLearning Online Strategy Team, Department of Education & Training, on telephone (03) 9637-2147 and immediately provide written confirmation to the eLearning Online Strategy Team. In addition I agree that the name and/or a photograph of the Student may be published in written promotional material such as Press Releases, newspaper articles, website, CD Rom, newsletters and general promotional materials related to the Wide Open Code Competition. Date: ____/____/___________ Signature: ____________________________________________________________ (parent/guardian) Signature: ____________________________________________________________ (Student) Name of Parent/Guardian: __________________________________________ Contact Telephone Number:__________________________________________ Name of Student: __________________________________________ Name of School:__________________________________________ All enquiries in relation to this authorisation should be direction to the eLearning Online Strategy Team, Department of Education and Training, on telephone (03) 9637-2147.