McLane Church Photo/Video Release Form (PowerZone Kids & G3 Youth)


Parent/Legal Guardian Name *
Parent/Legal Guardian Name
Child/Teen Name(s) *
Child/Teen Name(s)
McLane Church Site *
Parent/Legal Guardian Phone Number *
Parent/Legal Guardian Phone Number
Photo/Video Release *
Please check your preference regarding the use of images and/or videos taken of your child(ren)/teen(s) at McLane Church:
As the parent/legal guardian of your child(ren)/teen(s), please electronically sign this form with your FULL NAME by typing it in ALL CAPS.