Website & Social Media Personal Release Form

I hereby grant permission to Integrated Health & Wellness Center (IH&WC)/Spero Clinic and its assigns and licensees to take photographs or videos of me, and to make recordings of my voice. I give the IH&WC/Spero Clinic permission to use these images, videos, and recordings, as well as my likeness, name, and voice, as follows:

In consideration of my participation in the foregoing, the undersigned acknowledge and agree to the following:

The use may include reproduction, distribution, derivative works, display, and performance.`The use may be in composite or modified forms and in any media, now known or laterdeveloped, including without limitation newspapers, television, radio, the World Wide Web, and social media.The use may be for any purpose throughout the world and in perpetuity, including, without limitation, education, trade, advertising, and promotion.I further acknowledge that I will not be compensated for these uses, and that IH&WC/Spero Clinic exclusively owns all rights to the images, videos, and recordings, and to any derivative works created from them.I waive the right to inspect or approve of the uses of any printed or electronic copy.I hereby release IH&WC/Spero Clinic and its assigns and licensees from any claims that may arise from these uses, including without limitation claims of defamation or invasion of privacy, or of infringement of moral rights or rights of publicity or copyright.This Release is binding on me, my heirs, assigns, and estate.IH&WC/Spero Clinic is not obligated to use any of the rights granted under this Release.This Release expresses the complete understanding of the parties.

I grant permission:

I grant permission to Integrated Health & Wellness Center (IH&WC)/Spero Clinic and its assigns and licensees to take photographs or videos of me, and to make recordings of my voice. I give the IH&WC/Spero Clinic permission to use these images, videos, and recordings, as well as my likeness, name, and voice.

I do NOT grant permission:

I do NOT grant permission to Integrated Health & Wellness Center (IH&WC)/Spero Clinic and its assigns and licensees to take photographs or videos of me, and to make recordings of my voice. I do NOT give the IH&WC/Spero Clinic permission to use these images, videos, and recordings, as well as my likeness, name, and voice.

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