Website Picture Waiver

Please fill out and submit a form for each child. It is required for all children age 17 and below. An online registration will require the parent to sign the hardcopy when the child attends his/her first activity at Dayspring at Alton Road.

For valuable consideration received, I hereby grant to Daysypring at Alton Road Baptist Church, the irrevocable and unrestricted right to use and publish photographs of me, or in which I may be included, for advertisement purposes and any other purpose and in any manner and medium; to alter the same without restriction; and to copyright the same. I hereby release Dayspring at Alton Road Baptist Church from all claims and liability relating to said photographs. This waiver is for minors only. A minor is defined as anyone who has not achieved their 18th birthday.

This waiver is effective for 1 year from the signature date and will be void only when another waiver form is received by Dayspring at Alton Road Baptist Church or the minor achieves their 18th birthday.

To view the website, please visit dayspringcolumbus.org.

I do agree to this waiver and understand my child's picture may be posted online.

I do not agree to this waiver. My child's picture cannot be posted online.

Child’s Name (Print)

Parent’s Name (Print) Date

Child’s Birthdate

Signature (or if minor, signature of parent/guardian)

Address Phone XXX-XXX-XXXX

City State Zip Code

Witness of Dayspring Baptist Church:

Print Signature