Please explain each of the areas checked
Please list all medications currently being taken
Media Consent - I hereby give my full consent to La Jolla Presbyterian Church (LJPC) and it's ministries to record (video, photograph, audio recording or other) my and my child's participation in any programs or events associated with LJPC. Further, I hereby transfer and assign to LJPC the exclusive rights to use and to authorize others to use said images, video, photography, audio recordings or other, for promotional and educational use or resource sale in the future. I understand that my image, voice or video recording may be used, but my name or personal information will never be shared publicly without additional, separate consent.