Permission To Use Photo Release Form

Permission To Use Photo Release Form
Beneficiary of the Hydrogen Hygiene Targeted Methods™ or the Parent/Legal Guardian if the Beneficiary is a minor:
First Name

First NameLast Name
Last Name

First NameLast Name
Phone (mobile)
Format: (000) 000-0000.
Email Address
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Today's Date

MonthDayYear
Date
About the Photo Release Form
This Hydrogen Hygiene Targeted Methods™ Permission to Use Photo Release Form (the "Photo Release Form"), signed at the date mentioned above and under signature below, is made between the company I CHOOSE – I AM NOT A VICTIM CORP (the "Company"), represented by Gabriela Humailo Parker as the Founder/CEO and all the Beneficiaries of Hydrogen Hygiene Targeted Methods™ or the Parent/Legal Guardian of the Beneficiary of the Hydrogen Hygiene Targeted Methods™ if the beneficiary is minor, collectively known as the "Parties."
Permission to Use Photograph/Photography Consent
I, the undersigned, consent to the taking of before-and-after photographs of the Hydrogen Hygiene Targeted Methods™ session-focused area (face, body) to document the Hydrogen Hygiene Targeted Methods™ potential results.
I also hereby grant the Company the absolute right and permission to use my photographs in any manner or media, including, but not limited to, the following purposes: in the Company's portfolio, marketing materials, social media, and/or websites, educational materials, publications, advertising and promotional materials, and press releases.
I understand that the Company will not use my name and other identifying information with these photographs without my written consent. If I choose not to consent to the use of photos for these purposes, it will not affect the quality or delivery of the Hydrogen Hygiene Targeted Methods™.
Please indicate your consent to the use of photographs.
Description of Photograph(s)
Address where the photographs were taken:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

ZIP / Postal Code
Country
Date of photographs taken:

MonthDayYear
Date
No Compensation
I understand that I will not receive any monetary compensation for the use of my photographs.
Rights Granted
I grant the Company the following rights:
- The right to edit, alter, copy, or distribute the photographs for any lawful purpose.
- The right to use my name in connection with the photographs only with my written consent.
Release and Waiver
I hereby release and discharge the Company, its employees, agents, and representatives from any claims, demands, or causes of action that I may have now or in the future for defamation, invasion of privacy, or violation of the right of publicity or any other right arising out of or relating to the use of photographs.
Signature
By signing below, I acknowledge that I have read and understood this Hydrogen Hygiene Targeted Methods™ Permission to Use Photo Release Form and agree to the terms and conditions stated above.
The Individual Granting Permission
Beneficiary of the Hydrogen Hygiene Targeted Methods™ or the Parent/Legal Guardian if the Beneficiary is a minor *
Printed Name
Signature Date

MonthDayYear
Date
Should be Empty:

Permission To Use Photo Release Form

About the Photo Release Form

Permission to Use Photograph/Photography Consent

No Compensation

Rights Granted

Release and Waiver

Signature

The Individual Granting Permission