Media & Photo Release Family Promise of Genesee County

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Email *

By entering my name, I consent and give my permission for Family Promise of Genesee County (FPGC), or anyone authorized by FPGC, to use and reproduce the audio, film, video, and/or photographs recorded or taken of me (and my children under the age of 18, if applicable) in FPGC promotional materials or any other use authorized by FPGC. I understand that these audio/film/photographic materials belong to FPGC and may be used, transferred, or reproduced without compensation to me, and that they may appear in national or international publications, programs, websites, and social media platforms. *

Family Promise of Genesee County Witness (enter staff/volunteer name) *

I authorize the use of my name and the names of my children to be used with the pictures taken of my family. I attest I am the legal parent or guardian of any minors I am authorizing this release for. *

Yes

Cell Phone of Person authorizing *

Today's Date *

YYYY

Send me a copy of my responses.

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