Page 147 | Plains Baptist Church Lincoln

Media Release

I give my permission to Plains Baptist Church for myself and my child(ren) to be photographed, videotaped or filmed in conjunction with church related events to include but not limited to: Teen Camp, Church Services, Church Activities, Character Quest, and Youth Activities; and acknowledge that no compensation will be paid by Plains Baptist Church or any third party to my child or me or any other person on behalf of my children or me with respect to such use of my child’s images. I understand that these photographs, tapes or film, or reproductions, may be used by Plains Baptist Church for promotional or advertising purposes, also without compensation by Plains Baptist Church or any third party.

You may use one form for up to eight children.

Name (Required)

Email Address (Required)

1st Child's Full Name (Required)

2nd Child's Full Name

additional child

3rd Child's Full Name

Additional Child

4th Child's Full Name

Additional Child

5th Child's Full Name

Additional Child

6th Child's Full Name

Additional Child

7th Child's Full Name

Additional child

8th Child's Full Name

Additional child

I give my permission to Plains Baptist Church for myself and my child(ren) to be photographed, videotaped or filmed in conjunction with church related events. and to be used without compensation by Plains Baptist Church or any third party. (Required)

Your typed name represents your binding signature. Parent or Guardian's Full Name:

Solve 7 + 3 = ?

Plains Baptist Church Lincoln

2902 Randolph Street
Lincoln, NE 68506

Links:

pbclincoln.org

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