I hereby authorize First Unitarian Church of Victoria, (hereafter referred to as FUCV), to take photographs of me and of the minor children, 18 years and younger, listed below and to publish the photographs in printed, online and video based materials and to share these with the Canadian Unitarian Council (hereafter referred to as CUC) for the same purposes.

I understand that my name, and those of any minor children listed below, will not appear on FUCV or CUC online media, including websites, without my additional permission.

I acknowledge that I am not entitled to any compensation for signing this form nor for any photographs taken or published and that I sign this form freely and without compulsion.

I hereby release and hold harmless FUCV and CUC from any reasonable expectation of privacy or confidentiality for myself, and for any minor child or children listed below associated

I hereby release FUCV, CUC, their contractors, their employees and any third parties involved in the creation or publication of FUCV publications and of CUC materials from liability for any

claims by me or any third party in connection with the publication of my photo or those of the minor children listed below.

I understand that I may withdraw this authorization for any future publication on my behalf, or if applicable on behalf of the minor child or children listed below, in writing to the Privacy Officer, First Unitarian Church of Victoria, 5575 West Saanich Road, Victoria B.C. V9E 2G1 churchoffice@victoriaunitarian.ca

I attest that I am the parent or legal guardian of the child or children listed below and that I have full authority to consent and authorize FUCV to use their likenesses and names.