Name *

First Name

Last Name

Phone

(###)

###

####

Date *

MM

DD

YYYY

I grant First United Methodist Church of Lubbock, the right to take and use photos or videos of me for the promotion of First United Methodist Church of Lubbock and its ministries. These photo or videos would be used to demonstrate the activities, events, curriculum and environment that is experienced through our ministries. *

Yes

No

I further give my permission to First United Methodist Church to use photos or videos in printed and electronic media for the purposes of promoting the church and advertising First United Methodist Church. These photos or videos taken may be used in the church, its publications on its website, for press releases, advertisement, brochures, promotional materials, or whatever seems reasonable and acceptable to promote our church and ministries. *

Yes

No

I have read and understand the above. I understand by submitting this form to First United Methodist Church, Lubbock, I am giving permission. *

Yes

No