Media Release Form for Temple Lutheran Church
If you're receiving this link, you have given us media to use for a Temple Lutheran Church program that will be made available online or in print or you or your child will be participating in a TLC program for which photos or videos may be taken and used online or in print. This release form gives us permission to use these materials as noted. Please fill the form out separately for each person.
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This release is for (type name): *
Who is: *
I hereby grant Temple Lutheran Church of Havertown, PA permission to use my likeness in photographs, video recordings or digital photos in all its publications, including website entries and posted on the church’s social media, without payment or any other consideration. I recognize that my name may be associated with my likeness. I understand and agree that these materials will become the property of the organization and will not be returned. I hereby irrevocably authorize the organization to edit, alter, copy, exhibit, publish or distribute these photos for purposes of publicizing the organization’s programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of a photo of me. I hereby hold harmless and release and forever discharge the organization from all claims, demands and causes of action that I, my heirs, representatives, executors, administrators, or any other individuals acting on my behalf or on behalf of my estate have or may have by reason of this authorization. Temple Lutheran Church agrees to abide by the Electronic and Social Media section of the Child and Youth Safety Policy. TLC recognizes the delicate balance between desire for full participation by child and personal privacy. TLC will endeavor to work with parents and children on achieving this balance. *
Required
If the person named above is 18 years of age or older:
By typing my name below, I agree my electronic signature is the legal equivalent of my manual/handwritten signature on this release.
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If person named above is under 18 years of age or not capable of providing consent:
I hereby certify that I am the parent or guardian of the person named above, and do hereby give my consent without reservation to the foregoing release on behalf of this person. By typing my name below, I agree my electronic signature is the legal equivalent of my manual/handwritten signature on this release.
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