In consideration of participating in Heartland Community Church of Rockford, Inc events, I give Heartland permission to use photographs and videos of myself or my child(ren) for the following non-profit use and without charge: display at a service or event or be used in a multimedia presentation, reprint and distribute in any Heartland Community Church non-profit publication with copyright to accompany photo or video when used, display on the Heartland Community Church website, or use at the discretion of Heartland Community Church.
  • This release is valid for one year from date signed.
  • Date Format: MM slash DD slash YYYY

*View Heartland’s general release form.