Event - Photography Release Authorization - R-30 - ST. MALACHY ROMAN CATHOLIC CHURCH

Event - Photography Release Authorization - R-30

Release for Diocesan Production for the Diocese of Fresno (DOF) and all Entities for the Diocese of Fresno (DOF)

Parents / Guardians: This form must be completed in order for your child to participate in this event or function. Please respond accordingly to the authorized use of your child's photograph or video image in a DOF produced public-relations document.

NAME OF PARISH OR SCHOOL: St. Malachy Church

NAME OF GROUP: CCD

NAME OF EVENT: K-5

DATE OF EVENT: 2021/2022

PARTICIPANT AGREEMENT
I hereby grant the Diocese of Fresno and its entities (hereinafter called Producer), their nominees, designees, and successors full authorization and the absolute right and permission to sell, assign, convey, reproduce, copyright, use or publish photographic reproductions, portraits, or pictures of me, motion picture or video tape pictures of me, or in which I may be included in whole, in part, or in composite, or in which character or form is distorted, in conjunction with my own or any other picture, product, person, name or reproduction, in color or otherwise, made through any media and its studios or elsewhere, for art, advertising, commerce, business or trade, or any other lawful purpose whatsoever.

I hereby waive any right I may have to inspect or approve the finished product or the advertising copy that may be used in connection therewith, or the use to which it may be applied.

I hereby release, discharge and agree to hold harmless PRODUCER, its nominees, designees, or successors, and assignees or others for whom they are acting from any liability of any nature or description by virtue of any use whatsoever, whether intentional or otherwise, or from any change that may occur or be produced in the taking of said picture or pictures, or any processing tending towards the completion of the finished product, unless it can be shown that said use or change is solely for its purpose of subjecting me to conspicuous ridicule, scandal, reproach, scorn and indignity.

* Indicates required field

SIGNATURE OF PARTICIPANT *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

PARENT / GUARDIAN AUTHORIZATION FOR A MINOR

If the participant is under 18 years of age, the parent or legal guardian of the above participant must provide the following information and must check one of the following and sign.

Choose One of the following: *

As the parent and/or legal guardian of the above named participant, I DO HEREBY CONCENT AND GRANT PERMISSION to all of the foregoing. As the parent and/or legal guardian of the above named participant, I DO NOT GIVE MY CONCENT for my child to be photographed, but I understand that it will be the responsibility of the participant to make every effort possible from participating in any posed pictures. If a picture or pictures are inadvertently taken, then I agree to review the photographs or video within the given frame in order to identify my child to avoid any reproduction or usage of the image and/or images.

SIGNATURE OF PARENT / GUARDIAN *

First

Last

SIGNATURE OF WITNESS *

First

Last

DATE (MM/DD/YYYY) *

Submit