I the undersigned, hereby consent to allow BioScultp Body Weight Loss Centers, it's affiliates and all its subsidiaries to use my before and after digital photographs , measurements, written and audio/video testimonial and grant all rights to any digital recordings of me in the possession of BioScultp Body Weight Loss Centers, it's affiliates and all its subsidiaries or hereafter acquired, including all rights to exhibit and publish the works in print and electronic form, publicly or privately, and to market and sell copies and to use these in any and all types of media, now or hereafter known, for the purpose of marketing and promotions. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used except as provided herein.
I further consent that no part of my name MAY NOT be revealed therein unless I allow any part of my name to be revealed.
I understand that I will receive a complimentary single product of my choice or I will receive a complimentary service of my choice. I understand that this credit value is non-transferable.
I understand that there will be no additional compensationor consideration for me for my digitial photographs, measurements, written testimonial and audio/video testimonial or for any subsequent use. I represent that I am at least 18 years of age, have read and understand the foregoing, and am competent to execute this agreement.