St.
Mary's of
Crescent
PERMISSION
FOR PHOTOGRAPHS/VIDEOTAPES/FILMS
I hereby authorize and give my consent for the taking of
pictures
(moving/still) of
and further give my permission for their
reproduction for:
- Teaching puposes only
- News Release
- Publication
- Community awareness programs
______________
___________________________________
date
signature
______________________________
relationship
This space may be used to state any restrictions you may have on the
above.