Photo / Video Release
Form
Adult Form
I / We,
_____________________________________________________, hereby
c Do give The Worship Center
permission;
c Do Not give The Worship Center
permission;
to take photographs and/or videos of me or photographs
and/or videos in which I may be involved with others for the purpose of
promotional use in printed and/or electronic form. Photos / Videos may be used
on, but not limited, to the church website www.TheWorshipCenterCT.org and
Taking the Heights Campaign Follow-Up Media.
I release legal rights of ownership of the photos / videos
to The Worship Center and discharge The Worship Center from any and all claims
that may or may not arise from the use of the photos / videos.
I am above the age of 18.
I have read the foregoing document and fully understand its contents.
Printed name: ___________________________________________________
Address:
_______________________________________________________
Date:
______ / ______ / ______
Please sign and fax
to 860-228-2730 or mail this form to:
The Worship Center, P.O. Box 1435, Hebron, CT 06248-7435.