Media Waiver

1. YOUR AGREEMENT

I grant permission to Claysburg Church of God, hereinafter known as the “Media” to use my image or the image of the person(s) stated below (photographs and/or video) for use in Media publications including:

☑ Videos ☑ Email Blasts ☑ Recruiting Brochures ☑ Newsletters ☑ Magazines ☑ General Publications ☑ Website and/or Affiliates ☑ Other

By agreeing to this media release form, you agree to be bound by, and to comply with, these Terms and Conditions. If you do not agree to these Terms and Conditions, please do not use tick the box.

PLEASE NOTE: We reserve the right, at our sole discretion, to change, modify or otherwise alter these Terms and Conditions at any time. Unless otherwise indicated, amendments will become effective immediately. Please review these Terms and Conditions periodically.

2. TERMS

I hereby waive any right to inspect or approve the finished photographs 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, and I waive any right to royalties or other compensation arising from or related to the use of the image.

3. CERTIFICATION

By signing this form, you hereby acknowledge that you are:

A) 20 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.

B) 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.