Photo & Video Release Form

East Ohio Conference of The United Methodist Church

Photo & Video Release Form
I hereby grant to the East Ohio Conference of The United Methodist Church, its local churches, representatives, employees and volunteers, the right to record my name, likeness and voice as part of church related video, audio or photographic productions. I further give consent for my name, likeness and voice to be included in print, electronic and/or webbased productions to promote the ministries of The United Methodist Church.
I have read and understand the above.
Printed Name:
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
I am 18+ years of age I am less than 18 years of age
Signature *

Clear
Parent's Signature (if less than 18 years of age)

Clear
Date SIgned

Month Day Year
Date
This form will be valid for one year from the date listed above unless another form is completed and submitted to the church office.
Should be Empty:

East Ohio Conference of The United Methodist Church