I hereby authorize Reveille United Methodist Church, located in Richmond, Virginia (“Reveille”), to use, reproduce, and distribute my name, voice, likeness, photograph, and/or any other representation of me in connection with printed materials or other media it distributes, displays, transmits, or exhibits. Such distributions, displays, transmissions, or exhibits may include, but are not limited to, publications, newsletters, magazines, brochures, CD ROMs, websites, social media, and/or videos. I understand that my authorization grants Reveille the right to use, reproduce, and distribute my name, voice, likeness, photograph, and/or any other representation of me without compensation or further notice. I hereby release and discharge Reveille for any and all liability arising out of or relating to the foregoing.

By submitting information on this form, I consent to allow the minor(s) named below to participate in the activities described above and allow the information obtained from the below named minor(s) to be used and shared as described above. I represent and warrant that (i) I am eighteen (18) years of age or older and am legally competent to execute this Consent and Release Form under the laws of my country and (ii) I have the legal authority to represent the below named minor(s).

I understand that the terms herein are contractual and not a mere recital, and that this Consent and Release Form is legally binding on me. I have read and fully informed myself of the contents of this Consent and Release Form before submitting my information and photograph.

Please note: The information below will be used to update the church database and in the online member directory. The online directory is password protected so that only members listed in the directory will have access to the contents.

PLEASE AGREE TO TERMS

I understand that the terms herein are contractual and not a mere recital, and that this Consent and Release Form is legally binding on me. I have read and fully informed myself of the contents of this Consent and Release Form before submitting this information to Reveille United Methodist Church.