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Family Outreach

Photo/Video Release Form



Please list the names and ages of each child attending the event individually in the spaces below.

CERTIFICATION AND RELEASE STATEMENT

Are you the legal guardian of child(ren)?
I certify that the information given herein is true and complete and that the submission of this form is the same as my signing this form.
I hereby give permission for images and/or recording of myself and my minor child(ren) listed below, obtained via audio, video, photo, and/or digital camera, to be used soley for the purpose of Christian Heritage's promotional material and publication. I wave any rights of compensation or ownership thereto.
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