Please fill out and sign the form below.

to the use and reproduction by Refuge Outfitters for Christ’s Kingdom, Inc., a Non-Profit organization, of

any and all photographs and any other audio/visual materials that are taken of:

for promotional printed material, educational activities, exhibitions or for any other use for the benefit of the program.

This consent release applies to all family members & caregivers of this client attending. PLEASE specify if you wish to exclude other family members or yourself and submit as soon as possible, thank you.

Your consent allows us to share the joy and spread the great news of how our donators are blessing the lives of your children.

Date revised: May 4, 2016