I hereby give Our Lady of Perpetual Help Church permission to use a photograph of the minor(s) (person under the age of 18) listed below on its website. I understand that there will be no identifying information (e.g. name, age, grade, etc.) about the minor on this website.

This permission for web page photographic display of a minor will be in effect annually from Jan 1, 2008 until Jan 1, 2009 unless this permission is revoked by written notice to Our Lady of Perpetual Help Church.



Name of Child/Children:____________________________________________
________________________________________________________________
________________________________________________________________


Date: _____________________________


Parent / Guardian: _____________________________ Signature