Name of Children (Required)

I, Guardian grant permission and consent to Oregon Trail Church of God for the use of the following photograph(s) or video(s) as identified below for presentation under any legal conditions. (Required)

I understand that there shall be no payment for this release, there are no royalties, fees, or other compensation that shall become payable to me by reason of such use. (Required)

I understand that with my authorization below the photo/video may never be revoked. We, Oregon Trail Church of God and Guardian, understand and agree to the aforementioned terms and conditions. (Required)

Date (Required)