BEWARE. The scammers are at it again. They are sending out emails proposing to be Father Jerry asking for you to respond as he needs a favor. Father Jerry would never solicit in this manner.

Media Release Form For Minors

I acknowledge that I am parent/Guardian of (minor listed below) hereby allow the use of my audio and/or visual image by the Archdiocese of Detroit and/or St. Paul of Tarsus parish, for whatever purpose it sees fit, provided that it does not slander or that it is not used to make false claims against any person or institution.

My Audio and/or visual image may be recorded and reproduced for program material or for promotional material.  I also indemnify myself from the use of my audio and/or visual image taken out of context by the Archdiocese of Detroit or St Paul of Tarsus parish.

By typing your name below, you agree to these terms. 

Permission
Message I acknowledge that I am parent/Guardian of (minor listed below) hereby allow the use of my audio and/or visual image by the Archdiocese of Detroit and/or St. Paul of Tarsus parish, for whatever purpose it sees fit, provided that it does not slander or that it is not used to make false claims against any person or institution. My Audio and/or visual image may be recorded and reproduced for program material or for promotional material. I also indemnify myself from the use of my audio and/or visual image taken out of context by the Archdiocese of Detroit or St Paul of Tarsus parish. By typing your name below, you agree to these terms.
Name
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Minor's Name
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Signature instructions Message field: By typing your name here you are signing the Media Waiver and Release Form electronically, which is the equivalent of your manual signature on this form.
Signature
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Date of Signature //
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Permission to give others copies of picture
Message Also, I need your permission in order to give participants copies of the pictures taken in the program that include your child. Please mark below if you give permission for your child's picture to be shared with other participants in the program.
Permission for Copies
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Parent/Guardian Signature
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By typing your name here you are signing the Media Waiver and Release Form electronically, which is the equivalent of your manual signature on this form.
Do Not Share My Child's Pictures With Anyone
Message SIGN HERE ONLY IF YOU DO NOT WANT YOUR CHILD'S PICTURES SHARED.
No Permission
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Please check here if you do not give permission for your child's pictures to be shared with the parish at all.
Signature (Only if You don't want Child's Pictured shared)
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By typing your name here you are signing the Media Waiver and Release Form electronically, which is the equivalent of your manual signature on this form.