Create in Me Art Studio Bible Camp
August 5-8, 9:00 am - 12:00 pm
1074 N Fairfield Rd, Layton UT
Parent name (first and last): *
Your answer
Parent address: *
Your answer
Parent phone number: *
Your answer
Parent email address: *
Your answer
Emergency contact name (first & last) *
Your answer
Emergency contact phone number: *
Your answer
Photo Permission & Release Waiver *
I hereby grant Light of the Valley Lutheran Church permission to use my child(ren)’s likeness in a photograph in any and all of its publications, including website entries, without payment or any other consideration. I hereby authorize Light of the Valley Lutheran Church to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing Light of the Valley Lutheran Church programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein the likeness appears. I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge Light of the Valley Lutheran Church from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.
Payment Options *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service