Consent Form

Phenix City SDA Photo & Video Consent Form

Name

This field is for validation purposes and should be left unchanged.

Name of Parent

First Last

Name of Child

First Last

Date

I hereby consent and authorize the Phenix City SDA Church or its assigns, to use my name and/or the names of my family members who are minors, as listed below, as well as my likeness, photos, videos and other information (or that of family members who are minors) for the purpose of news releases, advertising, publicity, publication or distribution in any manner whatsoever. I further consent to such use in their present form and to any changes, alterations, or additions thereto. I hereby release the Phenix City SDA Church from all liability in connection with all such uses.

Yes

Name for Signature

First Last