EmailMe Form - Photo and Directory Information Release Form

I hereby grant to Grace Academy (GA), located in Boone, NC the absolute and irrevocable right and unrestricted permission in respect of photographic portraits, editorial or any pictures GA had taken of my child or in which my child may be included with others, to copyright the same; to re-use, publish and republish the same in whole or in part, individually or in conjunction with other photographs, and in conjunction with any printed matter, in any and all media now or hereafter known, and for any other purpose whatsoever, for illustration, promotion, art, editorial, advertising and trade, or any other purpose whatsoever with restriction as to alteration; from time to time, or reproductions thereof in color, black and white or otherwise made through any media, including Facebook, Grace Academy’s website, Shutterfly, etc.

I hereby waive any right that I may have to inspect or approve the finished products or the advertising copy or printed matter that may be used in connection therewith or the use to which it may be applied.

I hereby release, discharge and agree to save harmless GA, its legal representatives or assigns and all persons acting under its permission or authority, from any liability in connection with the use of the photographs as aforesaid or by virtue of any alteration, processing or use thereof in composite form, whether intentional or otherwise, as well as any publication thereof even though it may subject me to reproach.

I understand that the photographs taken by GA will be included into stock files. I agree that the photographs, the transparencies thereof and the rights to copyright the same, shall be the sole property of GA, with full right of lawful disposition in any manner.

I hereby grant permission to GA to photograph the GA participant during activities to use the photographs in GA audio-visual and printed materials without compensation or approval rights.

Parent Signature *

Clear

Please sign by clicking down your mouse or using your finger on a touch screen device.

Directory Release

Grace Academy will publish a directory that will be disbursed via email. Included will be phone numbers, cell numbers, emails, and addresses. Please indicate which information you would like to make available to the Grace Academy families, and list the information for us to use.

Father's Name

First Last

Mother's Name

First Last

Home Phone

### - ### - ####

Father's Cell Phone

### - ### - ####

Mother's Cell Phone

### - ### - ####

Father's Email

Mother's Email

Home Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Mailing Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region