Moving And Grooving Pt

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M&G Photo Release

hereby grant Moving and Grooving Pediatric Physical Therapy permission to use my likeness in a photograph in any and all of its publications, including but not limited to all of Moving and Grooving Pediatric Physical Therapy's printed and digital publications. I understand and agree that any photograph using my likeness will become property of Moving and Grooving Pediatric Physical Therapy and will not be returned.
I acknowledge that since my participation with Moving and Grooving Pediatric Physical Therapy is voluntary, I will receive no financial compensation.
I hereby irrevocably authorize Moving and Grooving Pediatric Physical Therapy to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing Moving and Grooving Pediatric Physical Therapy's programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph.
I hereby hold harmless and release and forever discharge Moving and Grooving Pediatric Physical Therapy 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 this authorization.
hereby grant Moving and Grooving Pediatric Physical Therapy permission to use my likeness in a photograph in any and all of its publications, including but not limited to all of Moving and Grooving Pediatric Physical Therapy's printed and digital publications. I understand and agree that any photograph using my likeness will become property of Moving and Grooving Pediatric Physical Therapy and will not be returned. I acknowledge that since my participation with Moving and Grooving Pediatric Physical Therapy is voluntary, I will receive no financial compensation. I hereby irrevocably authorize Moving and Grooving Pediatric Physical Therapy to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing Moving and Grooving Pediatric Physical Therapy's programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge Moving and Grooving Pediatric Physical Therapy 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 this authorization.
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hereby grant Moving and Grooving Pediatric Physical Therapy permission to use my likeness in a photograph in any and all of its publications, including but not limited to all of Moving and Grooving Pediatric Physical Therapy's printed and digital publications. I understand and agree that any photograph using my likeness will become property of Moving and Grooving Pediatric Physical Therapy and will not be returned. I acknowledge that since my participation with Moving and Grooving Pediatric Physical Therapy is voluntary, I will receive no financial compensation. I hereby irrevocably authorize Moving and Grooving Pediatric Physical Therapy to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing Moving and Grooving Pediatric Physical Therapy's programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge Moving and Grooving Pediatric Physical Therapy 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 this authorization.
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Signature of guardian if under 18 years of age
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