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Name
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First
Last
Email
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Phone
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Your God Story
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Photo of Yourself
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Max. file size: 32 MB.
Please share a professional photo of yourself if you can, with as high resolution as possible.
Consent
(Required)
I agree
I hereby grant permission to BLENDED KINGDOM FAMILIES, LLC, and it’s agents and employees the irrevocable and unrestricted right to reproduce the photographs, video images, and/or audio soundbites taken of me, or members of my family, for the purpose of ministry use, publication, promotion, illustration, advertising, or trade in any manner or in any medium.
I hereby release BLENDED KINGDOM FAMILIES,LLC, and its legal representatives from all claims and liability relating to said photographs, video images, and/or audio soundbites. Furthermore, I grant permission to use my statements that are given with or without my name, for the purpose of advertising and publicity without restriction.
I waive my right to any compensation.
By signing this I acknowledge that I am over the age of 18, and that I am the legal guardian of my children that may be included in said photographs, video images, and/or audio soundbites, and that as guardian, I grant permission for each of my children to appear in said photographs, video images, and/or audio soundbites.
ACCEPTED AND AGREED:
Birthdate
(Required)
MM slash DD slash YYYY