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We value your privacy and will not share your pregnancy intentions to anyone.

Photo & Video Release

I hereby give my consent and permission to the Prestonwood Pregnancy Center (“PPC”) and Prestonwood Baptist Church, Inc. (“PBC”), collectively “Prestonwood”, of the foregoing for use by Prestonwood in advertisement, publicity, and/or for commercial or other ministry purposes:
  1. Photographs and/or video of me/my child(ren), and my family taken by Prestonwood; and
  2. Information I provide regarding my story, including any background and how PPC helped me and/or my family, recorded in any way by Prestonwood.
Photographs, video, and/or any recorded information as listed above shall hereafter collectively be referred to as the “Media.”
I waive any claims against Prestonwood and any of their affiliates or subsidiaries, and all of their agents and employees (collectively, the “Prestonwood Parties”) arising from or related to the Media or use of the Media, and waive and/or assign all rights (including copyright) in the Media to Prestonwood. Prestonwood, as the sole owner of the Media, shall have the exclusive right to control and determine the use, display, performance, reproduction, and dissemination of the Media. Specifically, I hereby allow the Media to be published via print, video, or website affiliated with Prestonwood, and/or displayed on social media.
Additionally, I understand that publication may be accomplished electronically via the Internet, and that after publication, Prestonwood will be unable to prevent persons from gaining access to the Internet, copying the Media, and subsequently using, altering, or republishing it without my consent. As such, I also specifically waive any claim for damages against Prestonwood for the unconsented use, alteration, or republication of the Media by third parties accessing the Internet or obtaining copies of the Media.
Given the prevalence of portable electronic devices, I understand and acknowledge that others including visitors and/or anyone present while I and/or my child is present at Prestonwood may take photographs and/or videos of myself or my child with or without my knowledge and with or without the knowledge of Prestonwood, and may publish such media without my consent.
I HEREBY AGREE TO FOREVER RELEASE, DISCHARGE, INDEMNIFY, HOLD HARMLESS, AND DEFEND PRESTONWOOD FROM ANY INJURIES, DAMAGES, CLAIMS, DEMANDS, ACTIONS, OR CAUSES OF ACTION WHATSOEVER THAT MAY ARISE OUT OF OR HAVE A CONNECTION WITH ANY PHOTOGRAPHING, VIDEO-TAPING, OR OTHERWISE RECORDING MYSELF OR MY CHILD’S LIKENESS, OR FUTURE PUBLICATION OF THE SAME, IN THE CONTEXT OF A PRESTONWOOD-RELATED EVENT, WHETHER FROM ACTS OF ACTIVE OR PASSIVE NEGLIGENCE ON THE PART OF PRESTONWOOD.
Adult Participant, Parent, or Legal Guardian Signature:
MM slash DD slash YYYY
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