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Indicates required field
Child's Name
*
First
Last
Parent / Guardian Name
*
First
Last
Gender
*
Male
Female
Parent / Guardian Cell #
*
Choose Age or Rising Grade
*
4 years old
5 years old
Rising 1st Grader
Rising 2nd Grader
Rising 3rd Grader
Rising 4th Grader
Rising 5th Grader
Rising 6th Grader
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Parent / Guardian Email
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Parental Consent and Release for Publishing or Showing Minor Child's Still or Moving Image
I understand that from time to time, pictures are taken during the activities at Meadowview Baptist Church, or under its direction, and then they are presented in various church-sponsored media. These include, but are not limited to: pictures, video productions, newsletters, television programs, web casts, brochures, handbooks, programs and Internet web pages. This form is to notify you that those meetings, events and activities (including worship and classroom settings) are considered public and they are videotaped and photographed and used in the above listed manner. Further, on occasion a child's image may be singled out and used as an identifiable image. In order for us to use an image of your child where they are not part of a larger group, we ask that you sign the waiver below to grant permission for us to use your child's image.
I hereby remise, release and forever discharge Meadowview Baptist Church, its agents and employees from any liability for any injury or action against the above-named minor resulting from the use of such pictures, video or other image in any medium utilized. This release includes that Meadowview Baptist Church will not be responsible for other user's reproduction, display, distribution of modification of the minor's images in any manner, nor will Meadowview Baptist Church be responsible for defamation, misrepresentation, criminal acts by any unauthorized use of Meadowview Baptist Church images by third parties.
I hereby release to Meadowview Baptist Church all right to copyright this work and or exhibit this work in print or electronic form publicly or privately. I also permit them to market and sell copies as necessary. I waive any rights, claims or interest that I or my child may have concerning these images. I understand that I will not be compensated in any way for the use of my child's photograph, whether it is a still or moving image. You have my permission to use my child's image in the media types listed above, as well as any new media formats that are developed in the future. I am at least 18 years of age, I understand the above statement and I am competent to execute this agreement.
Consent:
*
Yes, I give my permission.
No, I do not give my permission.
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New To MBC
About Us
Directions
Our Team
Ministries
Children
Students
Adults
Missions
Messages
Calendar
Groups
Membership
GIVING
jobs