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Image Use Revocation Digital Form
People attending St Andrew’s Presbyterian Church functions consent to the sharing of image(s) and/or video(s) taken of them while in attendance unless this completed form is submitted. Unless consent is revoked, these image(s) and/or video(s) will be used in conjunction with other images and videos to represent church members, church visitors, volunteers and community members.
Paper copy available to print here: https://drive.google.com/file/d/153a0Ur-WIZbNa0SYS8tsHu0LJZsZVoGb/view?usp=drive_link
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I do not grant St Andrew's Presbyterian Church permission to publish, in full or in part, any image(s) or video(s) of me, whether in print or in video, that includes me on their website, at the church, or related to social media outlets. I understand that this revocation will remain in force until I withdraw my request and that St Andrew's Presbyterian Church may require me to restate my intentions at some future date.
I do not grant St Andrew's Presbyterian Church permission to publish, in full or in part, any image(s) or video(s) of me, whether in print or in video, that includes me on their website, at the church, or related to social media outlets. I understand that this revocation will remain in force until I withdraw my request and that St Andrew's Presbyterian Church may require me to restate my intentions at some future date.
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1.
Select Revocation Option
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Add option
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Print Legal Name
Print Legal Name
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*If the individual listed above is a minor*
The person listed above is a minor. I am the guardian of the above named person and complete the form on their behalf. (If this does not apply, skip and complete the remainder of the form.)
*If the individual listed above is a minor*
The person listed above is a minor. I am the guardian of the above named person and complete the form on their behalf. (If this does not apply, skip and complete the remainder of the form.)
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E-Signature
By typing your name below, this acts as a formal signature and agreement to the image revocation form.
E-Signature
By typing your name below, this acts as a formal signature and agreement to the image revocation form.
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