Media Release Form

Please fill out this form if you are in or providing an audio or video recording for the church:

I,
,
grant Eastern Sierra United Methodist Church permission to use my image (in photos and/or video, volunteered) for use in Media Publications.

I hereby waive any right to inspect or approve the finished photographs or electronic
matter that may be used in conjunction with them now or in the future, whether that use
is known to me or unknown, and I waive any right to royalties or other compensation
arising from or related to the use of the image.

Either I am 18 years of age or older and I am competent to contract in my own name, or I am the parent or legal guardian of the below named child.
I have read this release before signing below, and I fully understand the contents,
meaning and impact of this release. I understand that I am free to address any specific
questions regarding this release by submitting those questions in writing or email prior to
signing, and I agree that my failure to do so will be interpreted as a free and
knowledgeable acceptance of the terms of this release.

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By filling out this form and submitting, I acknowledge that I have read and understand the contents of this form and my digital signature is a representation of this acknowledgement.