Trinity Lutheran Church: Media Release

By submitting the form below, you acknowledge that you have read and fully understand the following release:

I hereby grant permission to Trinity Lutheran Church and its subordinates, to use my name and/or photographs for use in Trinity Lutheran publications such as brochures, newsletters, and magazines, and to use my name/and or photographs on display boards, in electronic versions of the same publications or on the Trinity Lutheran Church website.

I hereby waive any right to inspect or approve the finished photographs or printed 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.

I hereby agree to release, defend, and hold harmless Trinity Lutheran Church and its subordinates for publishing and/or distributing the finished product in whole or in part,whether on paper or via electronic media, from and against any claims, damages or liability arising from or related to the use of the photographs, including but not limited to any misuse, distortion, blurring, alteration, optical illusion or use in composite form, either intentionally or otherwise, that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.

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Please select the paragraph which is applicable to your present situation:*
I am 18 years of age or older and I am competent to contract in my own name. 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 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.
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 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.

First Name: *

Last Name: *

Email Address: *

Telephone: *
(123-456-7890)

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(If Applicable):

Signature: *
(John Smith)

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