Saint Timothy's
Episcopal Church
Indianapolis, IN  USA

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St. Timothy’s Episcopal Church

Parental/Guardian Website Consent Form


We are sending you this parental consent form to both inform you and to request permission for your child's photo/image to be published on the Church’s web site and Facebook page. 

As you are aware, there are potential dangers associated with the posting since global access to the Internet does not allow us to control who may access such information. However, we at St. Timothy’s Episcopal Church do want to celebrate your child and his/her endeavors. Consequently, the law requires that we ask for your permission to post a photograph of your child.

Once signed, this agreement will be valid from 6/1/2013 until 5/31/2014 and must be renewed yearly.

If you, as the parent or guardian, wish to change the agreement, you may do so at any time by sending a letter to the church and such action will take effect upon receipt by the church. 

Check one of the following choices: 

□    I/We GRANT permission for my child’s photo/image to be published on St. Timothy’s website and/or Facebook page. 

□   I/We DO NOT GRANT permission for photo/image that includes my child’s photo to be published on St. Timothy’s website and/or Facebook page. 

Child’s Name: (please print)




Print Name of Parent/Guardian:




Signature of Parent/Guardian:





Date: __________________________