Rally Night April 2021 Sign Up
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Are you coming to Rally Night on April 28th?
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What's Your Name? (First & Last) *
What grade are you in? *
What's your parent's Email Address? *
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For your parent(s): MBC Photo Release Form
I, the parent of a child attending Middleton Baptist Church (Hereinafter known as "MBC"), agree to the following:

I understand that my child whose name is given above may be photographed at MBC youth events & programs. I understand that these photographs may be used in promoting the youth ministry and/or the church, either in print or on the internet.

With my name typed below I grant permission for my child to be photographed, or their images recorded for print or electronic use for promotional purposes. I understand that it is my responsibility to update this form in the event that I no longer wish to authorize the above uses. I agree that this form will remain in effect as long as my child attends MBC youth programs. I understand that there will be no payment for me or my child's participation in this release.
Parent/Guardian Name *
Date: *
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I agree to the above Photo Release Form *
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