Worship Arts KIDZ Registration Form

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Child Information

 
 
 
 
 
Parent Information

Please complete this section with contact information for parents/guardians.
 
 
 
 
 
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Activity Selection

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Medical Conditions and Allergies (Child)

 
 
In Case of Emergency

 
 
 
Media Release

I, the undersigned, on behalf of myself and/or my child(ren), grant St. Mark’s United Methodist Church (UMC) and its designees the right to use, arrange, reproduce, distribute and display, including by electronic means, the Materials specified in this Release (listed below), and/or by incorporating the Ma-terials into one or more St. Mark’s UMC works, throughout the world and forever, for purpos-es of printed materials, web pages, and other audio or video presentations


Materials:

Story/Article

Name of Individual

Voice

Visual Likeness (on photographs, video, film, digital media, etc.)

Quote(s)/Testimonial(s)


I release St. Mark’s UMC, its directors, officers, employees, agents and contractors from any and all claims that I may have now or in the future relating to this Release however arising, including but not limited to, invasion of privacy, right of publicity, trademark infringement, copyright infringement or defamation. I waive any right to review or approve any works creat-ed hereunder. I am of full legal age and have read this Release and am fully familiar with its contents, except that if I am not of full legal age, then this Release shall also be signed by my parent or legal guardian.
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Payment

 
 
 
 
 
 

Description

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