Authorization and Photo Release for Minor Child or Children
I hereby authorize Tenth & Broad Church of Christ (“the Church”) to publish photographs taken on of myself and/or the minor child or minor children listed below, and to utilize our names and likenesses, for use by the Church for use in print, online, in video-based materials, as well as in other publications.

I attest that I am the parent or legal guardian of the minor child or minor children listed below and that I have full legal authority to consent and authorize the Church to use their names and likenesses.

I agree to hereby release and hold harmless the Church the Tenth & Broad Church of Christ, their employees and agents from any reasonable expectation of privacy or confidentiality for myself and/or for the minor child or minor children listed below as well as from any and all liability for any and all claims arising out of or relating to my participation and/or the participation of the minor child or minor children listed below.

Email address *
Parent/Legal Guardian Name: *
Your answer
Date: *
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Street Address: *
Your answer
City, State & Zip: *
Your answer
Relationship to Children *
Your answer
Name of Minor(s) and Age(s): *
Your answer
Release Yes or NO *
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