Photo Release Form

10/16/2017
Steve Grenzow
Forms

Please electronically sign the photo release form if you’ll be attending a diocesan event where your photo or your child’s photo may be taken. If you prefer, you can print and sign a paper copy (send it to us or bring it with you to the registration table).

Photo Release

Release Text

I grant permission to The Episcopal Church in North Texas to use photographs taken of me on the date and at the location listed below for use in church publications such as brochures, newsletters, and magazines, and to use the photographs on display boards, and to use such photographs in electronic versions of the same publications or on web sites or other electronic forms or media without notifying me.

I hereby waive any right to inspect or approve the finished photographs or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the photograph.

I hereby agree to release, defend, and hold harmless the Episcopal Church in North Texas, including any firm publishing and/or distributing the finished product in whole or in part, whether on paper or via electronic media, from and against any claims, damages or liability arising from or related to the use of the photographs, including but not limited to any misuse, distortion, blurring, alteration, optical illusion or use in composite form, either intentionally or otherwise, that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.

I am 18 years of age or older and I am competent to contract in my own name.  I have read this release before signing below, and I fully understand the contents, meaning and impact of this release.

Location of Photo

First and Last Name *

Date(s)

Signature *

Clear

Signature of Parent/ Guardian if the person on the form is younger than 18

Photo Release Form

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