Darby Creek Church Photo and Video Release Form

Darby Creek Church Photo and Video Release Form
Please note, you MUST check either the "Opt In" box OR the "Opt Out" box. Once you check one, the other will not be required.
Opt In*

I'm OK with it
I hereby, authorize Darby Creek Church (DCC), to publish the photographs and/or videos taken of the undersigned minor children and their names, for use but not limited to DCC printed publications, website or social media.

I give permission to DCC to copyright, use and publish the photographs and/or videos of my child(ren) with or without names for any lawful purpose, including illustrations, advertising and web content, social media posts, etc.

I release, all claims against DCC with respect to ownership and publication including any claims of compensation. I confirm that I am the parent or legal guardian of the minor child(ren) and have the authority to authorize to use their photographs and names.
Full Name of Child 1
Full Name of Child 2
Full Name of Child 3
Full Name of Child 4
Full Name of Child 5
Full Name of Child 6
Opt Out*

No thank you.
I do not want any photos or videos of my child(ren) to be used in any church publication, website, social media, or in any other way.
Printed Name of Parent / Legal Guardian:*

First NameLast Name
Parent / Legal Guardian Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email
If you provide your email address, we will email you a copy of your completed form
Parent / Legal Guardian Signature*

Clear
Sign your name with your mouse / touchpad or with your finger if you have a touch screen.
After pressing the SUBMIT button below, please wait 15 to 20 seconds and you will be taken to a "Thank You" screen confirming your form was submtted.
Should be Empty: