Share Your Story
Participant Name
First Name
Last Name
Name of Parent/Guardian (for under 18 yrs)
First Name
Last Name
Congregation & City
E-mail
example@example.com
Your story
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If media is uploaded above, please provide permission for use here:
I grant permission to Water's Edge Ministries, Serve Boldly, its agents, and its employees the irrevocable and unrestricted right to use the provided photographs and video taken of my child, myself, or members of my family for any lawful purpose including publication, promotion, illustration, advertising, trade, or historical archive in any manner or in any medium by Water's Edge Ministries or Serve Boldly. I hereby release Water's Edge Ministries and Serve Boldly its legal representatives from liability for any violation or claims relating to said images or video.
May we contact you to talk more about this experience?
Yes, please.
No, thank you.
Are you interested in being contacted to share your testimonial via video or audio recording?
Yes, please.
No, thank you.
Understanding
*
I understand my testimony, made on behalf of Water's Edge Ministries and Serve Boldly may be used in connection with publicizing, promoting, or reporting on programs, locations, ministries, or work.
Can we put your name with your story?
*
Yes. I authorize Water's Edge Ministries and Serve Boldly to use my testimonial and to include my name and brief biographical information in marketing materials. (ie first name, grade level, hometown)
No. I authorize Water's Edge Ministries and Serve Boldly to use my testimonial but request for you to change my first name and any identifying biographical information.
Signature of Participant/Parent/Guardian (18 yrs and older)
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