Opt-Out Form

I do not authorize Cassel Hills Church of Christ to use recordings or photographs of myself in whole or part for advertising, media, video, audio, or other marketing purposes. I hereby confirm that I am of legal age (over 18) and have every right to contract in my own name. I have provided a picture of myself to be used as reference to assure my dis-inclusion in any images used by Cassel Hills Church of Christ. I will notify photographers in my vicinity that I do not wish to be photographed. In signing this form, I understand that Cassel Hills Church of Christ will make reasonable efforts to avoid access to, or remove, my image or voice for all purposes identified herein.

Adult (Over 18)

Date Input

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Email

Child (Under 18)

Date Input

Child's Name

Parent's Name

Phone Number

Email

I hereby confirm that I am the Parent or Guardian.
I further affirm I have read the above “Opt-Out Form,” and am familiar with its contents.

Signature

Email a reference photo to office@chillscoc.com