Photo Consent Release Form

I hereby grant Hela Medical Spa permission to use my likeness in a photograph, video, or other digital media (‘photo”) in any and all of its publications, including web-based publications, without payment or other considerations.

I understand and agree that all photos will become property of Hela Medical Spa.

I hereby irrevocably authorize Hela Medical Spa to edit, alter, copy, exhibit, publish or distribute these photos for any lawful purpose on any Hela Medical Spa social media platform(s). In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo.

I hereby hold harmless, release, and forever discharge Hela Medical Spa from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of the authorization.

I authorize the use of Photographs for the following:

Educational Purposes such as Medical Procedure DemonstrationSocial Media and Online Publishing adsPrint Marketing AdvertisementsVideo and Television Media Advertisements

Name

Signature

Date Signed

Date

Upon submitting this form, you affirm that all your responsibilities and rights have been explained to you.