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Photo, Video, & Media Consent Form

Purpose

Orchard Park Presbyterian Church occasionally captures photos and videos during worship, programs, events, and ministry activities to share the life and ministry of the church.

Participant Information

Name of Minor/Vulnerable Adult

Date of Birth (if minor)

Parent/Guardian/Authorized Representative Name

Phone Number

Email Address

Consent

Please check one of the below options.

I GIVE PERMISSION for photos/videos of the individual listed above to be taken and used by Orchard Park Presbyterian Church for:

- Church Website

- Social media (e.g., Facebook, Instagram)

- Printed Materials (e.g., brochures, newsletters)

- Presentations or displays within the church

I grant permission to Orchard Park Presbyterian Church a royalty-free, worldwide right to use, display, or distribute any or all or excerpts of the photographs or recordings in any media listed above for reasonable purposes in connection with the mission and ministry of Orchard Park Presbyterian Church.

I DO NOT GIVE permission for photos/videos of the individual listed above to be taken or used.

Privacy & Safety Commitment

Images will be used respectfully and in alignment with Orchard Park's values.

Full names and identifying information will not be used without additional consent.

Images will not be used in a way that compromises dignity, privacy, or safety.

Ackowledgement

I understand that I may withdraw this consent at any time by contacting the church office in writing stating my intent to withdraw this consent, which withdrawal will be effective upon delivery of said writing to Orchard Park Presbyterian Church as to any future use.