Media Release Form

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Media Release Form

Permission for Photos *

Please select one of the options below

I HEREBY GRANT PERMISSION to Mater Dei Catholic Church to allow my child/myself to be photographed and/or interviewed. It is my understanding that this photograph/interview or portions thereof may be used for public view (i.e. parish, FSSP and diocesan websites, social media, publications, etc.). I agree to participate in this project without financial remuneration, and understand that this releases Mater Dei Catholic Church, the Priestly Fraternity of St. Peter (FSSP) and the Catholic Diocese of Dallas from any future claims as well as from any liability arising from the use of said photograph/interview.

I DO NOT GRANT PERMISSION for my child to be in photos that will be published or distributed in any way by Mater Dei Parish, FSSP and diocesan websites, social media, etc.

Required

LAST NAME OF FAMILY *

Please type in the last name of all adults/children in family

Name(s) of Children *

Please type names of Children to be photographed

Name(s) of Adults

Please type names of Adults to be photographed

Name(s) of Parent/Guardian *

Address

City, State, ZIP

Digital Signature (Please Type Your Name) *

Notice: By submitting this form with a digital signature, you agree to all terms above

Email of person submitting form *

Phone number of person submitting form *

Submit

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