Media Consent and Release
Name:*
E-Mail Address:*
Phone:
Address:
City:
State:
Zip Code:
I hereby consent to have the members of my family listed below photographed or video taped by St. Matthew's Ev. Lutheran Church. I also consent to St. Matthew's use of my family members' photograph(s), or likeness on the St. Matthew's website.
 Yes, I consent
Please type the names for whom you are providing consent (separated by commas): (Note: Names will not be posted online.)
I understand that I may cancel my consent by providing written notice to the church office.


Submit
"Prepare your minds for action; be self-controlled; set your hope fully on the grace to be given you when Jesus Christ is revealed." ~ 1 Peter 1:13