Harvest Festival – Titus Harvest Dome Spectrum Church

Please reserve your space early as we can only allow a certain number of cars to this event due to COVID-19.

Parent Full Name*
First Last
Email*
Phone*
Number of children attending*
Enter numbers only
Child’s name, age, and school
Child’s name, age, and school
Child’s name, age, and school
Child’s name, age, and school
Child’s name, age, and school
Tell us the car year, make & model you will be driving*
Address*
Street Address Address Line 2 City State ZIP Code
Consent*
I agree to the privacy policy.
Photo Release Disclaimer:

The Titus Harvest Dome Spectrum Church, Inc. take photographs of church sponsored community events to positively share the churches community events. These photos may capture your child's participation, directly or indirectly. These photos may be published through our website, social media pages, news bulletins, billboards, and ads. With this, we seek for your consent in allowing us to publish photos which may involve your child to the said platforms.

By signing this registration form, I hereby grant the releasee (Titus Harvest Dome Spectrum Church, Inc.) permission to use photographs in any of the following formats: website, social media pages, news bulletins, billboards, and ads. I hereby affirm that such release to the releasee does not constitute any form of compensation, including royalties arising from the photographs, to my benefit.

I understand and agree that photographs in the possession of the releasee shall become the property of the releasee. I hereby waive my right to inspect or approve the photographs by which my likeness appears.

I hereby hold harmless, release, and forever discharge Titus Harvest Dome Spectrum Church, Inc. from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

· I am of legal ageand I am the parent/ legal guardian of the children registered on this form
· I declare true my age of consent, and authorized my electronic signature as evidenced below: