Photo/Video Release Form

I grant permission to Hinman Holistic Health Institute, LLC, hereinafter known as the “Media” to use my image (photographs and/or video) for use in Media publications including:

I hereby waive any right to inspect or approve the finished photographs/video or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the image.

All statements, photographs, and/or video recordings taken of me (or the minor) by Media or its contractors, shall be the sole property of Media and may be used for promotional or other purposes as determined by Media anywhere in the world in its sole discretion.

This release shall be binding upon me, and our successors, heirs, assigns, executors, administrators, spouse, or next of kin.

I HAVE READ THIS DOCUMENT AND I UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS ON BEHALF OF MYSELF (INCLUDING RIGHTS RELATING TO PUBLICITY AND PRIVACY WITH RESPECT TO THE COMMERCIAL USE OF ANY STATEMENTS, AND/OR AUDIO OR VIDEO RECORDINGS) AND I SIGN THIS RELEASE FREELY AND VOLUNTARILY.