New Family Registration Form

Date

I hereby authorize Cross & Crown Church ('CXC') to publish the photographs taken of me and/or
the undersigned minor children, and our names, for use in the Cross & Crown's printed
publications and website.

I release Cross & Crown from any expectation of confidentiality for the undersigned minor
children and myself and attest that I am the parent or legal guardian of the children listed below and that I have the authority to authorize First Church of Round Hill to use their photographs and names.

I acknowledge that since participation in publications and websites produced by Cross & Crown Church is voluntary, neither the minor children nor I will receive financial compensation.

I further agree that participation in any publication and website produced by First Cross & Crown confers no rights of ownership whatsoever. I release Cross & Crown Church, its officers, trustees, and
its employees from liability for any claims by me or any third party in connection with my participation or the participation of the undersigned minor children.

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