PHOTO/VIDEO RELEASE WAIVER FOR MINORS

Your name *

Email address *

STUDENT'S NAME/S *

Please list below Full Name/s of child/children for which you are the legal parent or guardian.

Digital Waiver (Please check box to agree that you have read the below statement and agree to the terms stated below) *

I agree that I am the parent or legal guardian of the student mentioned above. I grant my permission to Colonial Heights Baptist Church (The Heights) to use videos or photographs of my student for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, social media posts and web content. Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

The checking of this box serves as your signature and agreement to the above waiver. Please type your name below to certify that it is you completing the form and agreeing to the above terms. *

Please type your first and last name below (By typing your name you agree that you are 18 years of age or older and are the legal parent or guardian and represent the student listed above) *

Today's Date *

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