Last Updated: April 10, 2012
Subject: PARENTAL AUTHORIZATION AND RELEASE FORM; Grace Covenant Presbyterian Church (PCUSA) Orlando, FL
Date: _______________________, 20__
1. For good and valuable consideration, the sufficiency of which is hereby acknowledged, I hereby grant to Grace Covenant Presbyterian Church, Orlando, Florida, along with its agents, successors, assigns and licensees (the “Church”), the right to use, publish, distribute, exhibit, advertise and exploit photographs, pictures, portraits, images, videos, electronic representations recorded, and likeness, of my minor child, __________________ (“my Child”) (hereinafter collectively “Photography”), in and in connection with any and all informational, marketing, advertising and any other form or type of material or web site pertaining to, for or on behalf of the Church or any of its or affiliated organizations, in all manner, form and media, whether now known or hereafter developed, throughout the Universe, in perpetuity.
2. I agree that all such Photographs, and the copyright(s) embodied therein, are owned exclusively by the Church, and that the Church or its designee(s) may register such copyright(s). If I or may Child should receive any print, negative or other copy of the Photography, I/we will not authorize use by anyone else. I further acknowledge and agree that neither I nor my Child has or shall have in the future any ownership interest whatsoever in any copyright(s) (i) in the Photography; or (ii) in any of the informational, marketing, or advertising material, or any other material which utilizes, incorporates or consists of the Photography.
3. I agree that no material need be submitted to me for any further approval and that The Church shall be without liability to me or my Child for the use or alteration, in any fashion, of the Photography or any portion thereof.
4. I consent to the use of my Child’s name or any fictitious name that may be chosen in connection with the Photography.
5. I warrant and represent that this release does not in any way conflict with any existing commitment by or on the part of my Child.
6. Nothing herein shall constitute any obligation on the Church to make any use of any of the rights granted or reserved herein.
7. MY CHILD IS NOT CURRENTLY A MEMBER OF ANY PERFORMING ARTIST UNION.
8. This consent and grant of rights is given in exchange for valid consideration and is irrevocable so that the Church may proceed in reliance thereon.
9. This release shall be governed by the internal laws of the State of Florida. Notwithstanding any provision of law to the contrary, no ambiguity in this release, if any, shall be construed against the Church as the draftsman. Any dispute which may arise between the Church and me, including but not limited to disputes regarding interpretation of this general release, shall be resolved by an action brought by either party against the other only in the courts located within Orange County, Florida, and I hereby expressly consent to exclusive jurisdiction therein.
NAME (PRINT): _______________________________________
SIGNATURE: _________________________________________
ADDRESS: ___________________________________________
PHONE: _____________________________________________