Permission to Photograph/Video Form

I give permission for Real Life Church to photograph/video my child.

Parent or Guardian First Name

Parent or Guardian Last Name

Child's First Name

Child's Last Name

For the following purposes, please check the appropriate box below

First and last names may be displayed.

You understand that it is your responsibility to update this form in the event that you no longer wish to authorize one or more of the above uses.

Signature

Date Input