Media Release Form

Model & Subject Release

I hereby give Highland Baptist Church the right and permission to publish, without charge, photographs taken of me during church related activities and events. These photographs may be used in whole or in part, and may be used in publications and in audio-visual presentations, promotional literature and materials, advertising, website or in other similar ways. In addition, I grant Highland Baptist Church the right to use and incorporate, in whole or in part, video footage taken as a result of my participation in Highland Baptist Church activities.

By checking the box marked “Accept”, filling out the following agreement (where applicable), initialing it, and answering the skill-testing-question, I give Highland Baptist Church permission to take photos and/or video of me for the purposes stated above. In addition, I wave any right to financial reimbursement for the reproduction of such photos or video, now or in the future.

Highland Baptist Church will NEVER sell or redistribute this media to other people, organizations or websites. This material is for the sole use of Highland Baptist Church for the reasons stated herein. You may modify or withdraw your permission at any time by notifying the office here or by filling in your information and then checking the “Decline” box below. Highland Baptist Church has and will continue to respect its members’ privacy by not distributing member names or addresses to anyone for any reason other than Highland Baptist Church related activities.

REQUIRED: AcceptDecline

First Name: Last Name:

Email: Phone:

My Initials &rarr

Parent or Guardian permission if participant is under the age of 18:

Child's First Name: Child's Last Name:

Parent's Initials &rarr


Digital Signature &rarr answer this skill-testing-question:

Highland Baptist Church uses photographs or video of some of its members to support and enhance its ministry. These might be rehearsed or posed photographs or videos, or they might be candid photographs and videos. Their purpose might be for use in worship services or other programs of the congregation, for advertising the ministries or programs of the congregation, or to post on the congregation’s website. Group or individual photographs and videos might be used. As much as possible, Highland Baptist Church wants to obtain specific permission from each person before using a photograph or video in which that person appears. You can assist the ministries of Highland Baptist Church by allowing us to use the photographs and videos of you. If you are a parent of a person under 18 years of age, you can also allow us to use photographs and videos of your children. If you will give this permission, you may do so either for a specific event, or for any photographs or videos taken in a calendar year.