2018-2019 Confirmation Retreat Registration
January 27 at Sacred Heart of Jesus and St. Cecilia School campus in Broussard from 8:30am – 6:00pm.
PHOTOGRAPH/VIDEO/AUDIO/MEDIA CONSENT & RELEASE FORM FOR MINOR (UNDER 18 YEARS OF AGE)
I, hereby consent to and authorize the Roman Catholic Diocese of Lafayette, Louisiana, (the Diocese) and all entities, representatives, employees, and agents operating under its authority to record, use, edit, reproduce, and/or publish photographs, video, audio, and/or other media that may portray and/or relate to the aforementioned minor child, his/her image, likeness and/or voice, without compensation. I understand that these materials may be used in various print and electronic media, including but not limited to the Diocesan website and the Diocesan publication, Acadiana Catholic, and/or for other endeavors related to Diocesan interests. I understand that the Diocese may use and/or publish materials relating to the aforementioned minor child and/or use his/her photograph, voice, video images, and other media relating to said minor child in any manner that the Diocese deems appropriate in order to promote and/or publicize its programs, or for any other lawful purpose. This authorization shall not expire and will remain effective indefinitely until rescinded in writing.
By signing electronically above I am verifying that I have read the above statements.