PHOTOGRAPH & VIDEO RELEASE

I/We hereby grant Grace Assembly permission to the rights of the child's image, likeness and sound of their voice as recorded on audio or video tape without payment or any other consideration. I/We understand that the child's image may be edited, copied, exhibited, published or distributed, and waive the right to inspect or approve the finished product wherein the child's likeness appears. Additionally, I/we waive any right to royalties or other compensation arising or related to the use of the child's image or recording.

I agree that Grace Assembly may use such images of the child with or without child's name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising and web content.

There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.

I/We acknowledge that I/we have completely read and fully understand the above release and agree to be bound thereby. I/we hereby release, defend, hold harmless and indemnify Grace Assembly from any and all claims for utilizing this material.

PARENT / GUARDIAN INFORMATION

MINOR / CHILD'S INFORMATION