Minor Child Photo Release Form

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

I hereby give permission and waive compensation for images of my child that are taken during Southport Presbyterian Church activities and used in:

(Check all that apply).

Publications and media releases promoting Southport Presbyterian Church where my child's image MAY BE identified by name.

Publications and media releases promoting Southport Presbyterian Church where my child's image WILL NOT BE identified by name.

The Southport Presbyterian Church website. I understand that my child will not be identified by name.

Parent/Guardian’s Signature:*

Date*

Parent/Guardian's Printed Name:*

First Last

Child(ren)’s Name(s):*

Click on the + sign to add multiple children.