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FCC Photo/Video Release Form
Each student/adult must fill out the information below completely. This form will become part of the First Christian Church's permanent file for the calendar year. This form is good for one year.
Email address *
Today's Date
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Student Name *
Your answer
Gender *
Date of Birth *
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Address *
Your answer
Indicate in which ministry you or your child participate *
Parent/Guardian Name (if under 18) *
Your answer
Home Phone: *
Your answer
Work Phone *
Your answer
Emergency Contact *
Your answer
Phone Number *
Your answer
Please Read:
I agree that FCC may photograph my child during their participation in any activity. I agree that FCC will be able to use them, in whole or in part, whether in original or modified form in any communication outlet, including social media. I hereby release and discharge FCC and all affiliated entities from any and all claims, demands, or causes of action that I have in connection with the use and exercise of the rights granted in this release. *
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