INSTRUCTIONS

FOR FILING APPLICATION FOR

EMPLOYMENT OF MINORS IN ENTERTAINMENT

Any person, firm or corporation who employs, engages, or otherwise permits persons to perform under 18 years of

age in the State of Georgia, whether or not such persons are bona fide residents of Georgia, for the purpose of

entertainment, must first obtain the consent to employ such person from the Commissioner of Labor in accordance

with O.C.G.A.39-2-18.

Application(s) must be completed in its entirety. lt is incumbent upon applicant (the employer) to furnish such

information and failure to do so may prevent Certificate of Consent from being issued. lf additional space is needed,

use plain bond paper for elaboration and attach to the application form.

Address application to:

Georgia Department of Labor

Child Labor Unit

Sussex Place

148 International Blvd., N. E.

Atlanta, Georgia 30303-1 751

MINORS MAY NOT BE EMPLOYED PRIOR TO ISSUANCE OF

CONSENT CERTIFICATE OR PERMANENT ID CARD

APPLICATION FOR EMPLOYMENT OF MINORS IN ENTERTAINMENT

TRADE NAME ADDRESS

BUSINESS ADDRESS AND PHONE NUMBER

SOCIAL SECURITY NUMBER

LOCAL ADDRESS AND PHONE NUMBER DATE OF BIRTH SEX

SHOOTING SCHEDULE/GA PLAY DATES

Begin Date:

End date:

DESCRIBE TYPE OF ACTIVITY TO BE PERFORMED BY MINOR. DESCRIBE ENVIRONMENT IN WHICH MINOR WILL BE PERFORMING

(EMPHASIS SHOULD BE GIVEN TO PHYSICAL AND MORAL INVOLVEMENT):

I hereby agree to comply with all laws and regulations governing the employment of minors in entertainment which are hereby incorporated by

reference. I further agree that during any period the minor's parent or legal guardian is not present, I expressly accept responsibility for the

minor's safety and well-being.

Signature of Employer and Title

IF APPLICABLE:

NAME AND ADDRESS OF TUTOR

STATE OF CERTIFICATION

LOCATION AND HOURS OF TUTORING

SCRIPT, IF ANY, MUST BE SUBMITTED PRIOR TO ISSUANCE OF CERTIFICATE OF CONSENT OR PERMANENT ID CARD

MINOR MAY NOT BE EMPLOYED PRIOR TO ISSUANCE OF CERTIFICATE OF CONSENT OR PERMANENT ID CARD

TO BE COMPLETED BY PARENT OR LEGAL GUARDIAN

I hereby expressly acknowledge and permit my child/ward named above to be engaged and perform for the above named employer. I also

expresily agreet6 be in attendance atalltimes during the engagementoremploymentof my child/ward (if under 16 years of age) with the above

named employer. lf for any reason I am unable to be in attendance, I expressly grant to the employer the responsibility for the safety and

well-being of my child/ward.

NAME, ADDRESS, AND TELEPHONE NUMBER

OF PARENT OR LEGAL GUARDIAN CONSENTING:

SIGNATURE OF PARENT OR LEGAL GUARDIAN:

DOL-4100 (R-1/92)

(Below is just information that you might find interesting---but it is the responsibility of the PRODUCTION company to get these in to the state. You do NOT need to get a permit beforehand. You will be contacted prior to your work date by production!)

Minors in Entertainment

ENTERTAINMENT EMPLOYMENT is defined as, "association through performance or participation with any motion picture production company, theatrical group or association, broadcasting (radio and television) or photographic modeling agency whether or not monetary remuneration is provided."

Employer Requirements

Complete an Employment of Minors in Entertainment application
Ensure application for each minor is legible and completed in its entirety
Ensure that the parent or guardian has completed and signed the appropriate portion
of the form
Submit application by FAX or mail along with a copy of the script or storyboard to:

Georgia Department of Labor
Child Labor Section
148 International Blvd., N.E., Suite 810
Atlanta, Georgia 30303-1751

Phone: (404) 232-3260
FAX: (404) 232-3264

Applications shall be submitted to the Georgia Department of Labor to be received not less than five (5) working days PRIOR to the first day the minor begins work in Georgia (including rehearsals). If there is no problem, a Certificate of Consent for the Employment of Minors will be issued to the employer.

It is illegal for a minor to begin work in Georgia prior to the employer receiving Certificate of Consent.

Hours of Participation

Minors 15 years of age and under may not work or be present at a production or performance site for more than 10 hours. Such 10 hour maximum shall include at least:

A one-hour break for meals;
A one-hour rest and recreation period, if the minor is present for more than four (4) hours; and
Any additional breaks as may be necessary to ensure the health, safety, and well-being of the minor.

Educational Requirements

When employment of minors 15 years of age and under requires absence from regular school curriculum in excess of two (2) consecutive calendar school days, an authorized tutor must be provided at the location of the production or performance. The tutor shall be provided by the production or performance company, and neither the minor, nor the minor's family, shall incur, in part or whole, the cost associated with the tutor. Each minor shall be provided at least three (3) hours of instruction per day.