• Testimonial Submission Form

    Thank you for your interest in submitting a testimonial video for Song for Charlie's social media platforms (Facebook, Instagram, TikTok, Snapchat, Youtube, Twitter). Our team will be reviewing all videos before they are posted. Submitting your video and this form, does not guarantee that your video will be used.
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  • Video Consent and Release

    I hereby give my consent to Song for Charlie, its affiliates and agents, to use my image and likeness and/or any interview statements from me in its publications, advertising or other media activities (including the Internet), without expectation of compensation or other remuneration, now or in the future.  This consent is given in perpetuity, and does not require prior approval by me.  This consent includes, but is not limited to: (Check where applicable)

  • By submitting this form, I hereby waive any right to inspect or approve the finished product, including written copy, wherein my testimonial appears.  In addition, I attest that any statements I make during my appearance are true and accurate.
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