Child's Name *

First Name

Last Name

Child's Birthday *

MM

DD

YYYY

Parent(s)/Guardian(s) Names *

First Name

Last Name

Best Number To Reach You *

(###)

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GP Kids Disclaimer *

I grant GracePoint, it's representatives, and employees the right to take photographs, video, and/or electronic images of any member of my family in our family ministries environments. I authorize GracePoint to coyright, use, and publish the photographs, video, and/or electronic images in print and/or electronically--with our without names--for any lawful purpose to highlight and promote our GP Kids environments. My selection of the agreement box below indicates that I have read and understand the above statement of release.

I Agree