Photo Waiver Release Form

Photo Waiver Release Form
Full Name of Individual *
(Subject of Photograph)
Individual is:*

of legal agea minor and represented by a parent/guardian
Name of Parent/Guardian of Person Subject of Photograph
I hereby grant First Parish Church in Beverly permission to photograph this individual:*

YesNo
I hereby grant First Parish Church in Beverly permission to use photographs of the above individual for:*

Internal Use - I authorize FPCB to use photographs of this person for lawful purposes within internal publications (such as a newsletter)External Use - I authorize FPCB to use photos of this person for lawful purpose in external publications (IE publically distrubuted via social media posts, website, printed materials, etc)I do not grant permission to use photographs of this individual
By signing this form, you affirm in understanding that the photographs in posession of FPCB shall become the property of FPCB, and hereby waive your right to inspect or approve the photographs.

By consenting to the release of images, you agree that you will not receive any form of compensation in cash or in kind.

You may rescind your authorization to the release of the photographs by writing FPCB a request.

I hereby hold harmless, release, and forever discharge FPCB from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.
Signature of Adult or Parent/Guardian*

Powered by Jotform SignClear
Date Signed*

MonthDayYear
Date
Should be Empty: