ࡱ> -/,q`  bjbjqPqP .::  _   $ h}L         ̓ / 0_    >", N$r>  _ << I hereby grant to Chapel Hill UMC and its representatives, employees, agents and assigns, the irrevocable and unrestricted right to use, reproduce and publish photographs of me, including my image and likeness as depicted therein, for editorial, trade, advertising or any other purpose and in any manner and medium; to alter the same without restriction; and to copyright the same. I hereby release Chapel Hill UMC and its trustees, officers, employees, agents, legal representatives and assigns from any and all claims, actions and liability relating to its use of said photographs. IN WITNESS WHEREOF, the undersigned, intending to be legally bound hereby sets their hand and seal the date written below. Student Name (Print) __________________________________ Date _______________ Student Signature ______________________________ Phone _____________________ Address ________________________________________________________________ City ______________________________ State ___________ Zip code______________ If under 18, signature of parent/guardian _______________________________________ Parent/guardian name (print) ______________________________________________     _ ` a M O #hQ#B* CJOJQJ^JaJphhhQ#H I   ` a M N O gdQ# ,1h/ =!"#$% @@@ NormalCJ_HaJmH sH tH DAD Default Paragraph FontRiR  Table Normal4 l4a (k(No ListHI`aMNO00000000000000000000HI`M@0@0@0@0@0@0@0@0@0@0@0   $(#%( \#&( #'( l#V*urn:schemas-microsoft-com:office:smarttagsplacehttp://www.5iantlavalamp.com/Z*urn:schemas-microsoft-com:office:smarttags PlaceTypehttp://www.5iantlavalamp.com/Z*urn:schemas-microsoft-com:office:smarttags PlaceNamehttp://www.5iantlavalamp.com/ XG%CCC__`aii%%MOll%C KQ#@CC,:CC@@UnknownGz Times New Roman5Symbol3& z Arial"h1ҶFH$fYr42HX)?Q#2I hereby grant to Chapel Hill UMC and its representatives, employees, agents and assigns, the irrevocable and unrestricted right to use, reproduce and publish photographs of me, including my image and likeness as depicted therein, for editorial, trade, aRandyKourtney AllerOh+'0l  ( 4 @LT\dI hereby grant to Chapel Hill UMC and its representatives, employees, agents and assigns, the irrevocable and unrestricted right to use, reproduce and publish photographs of me, including my image and likeness as depicted therein, for editorial, trade, aRandyNormalKourtney Aller2Microsoft Office Word@ @@ ys՜.+,0 hp|   I hereby grant to Chapel Hill UMC and its representatives, employees, agents and assigns, the irrevocable and unrestricted right to use, reproduce and publish photographs of me, including my image and likeness as depicted therein, for editorial, trade, a Title  !"#%&'()*+.Root Entry Fuѓ0Data  1TableWordDocument.SummaryInformation(DocumentSummaryInformation8$CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q