Video & Photographic Release

Video & Photographic Release Form

Thank you for volunteering to be recorded doing a session with Rob for YouTube

Below you'll find a standard video & photographic release form. Please fill it out and click send to qualify for your free session.
If you're new to working with Rob, your next step will be filling out his confidential online intake form.

Once Rob has all your information, he'll send a link to book your free session!

Name*

First

Last

Email address*

Address*

City*

State*

Zip Code*

Country*

Video & Photographic Release

I, ______________________, certify that I am over the age of 18 years. (Please type your name below)*

I, _______________ (“Releasor), hereby authorise Rob Nelson (“Releasee”) the right and permission to copyright and/or publish my image in video, photographs, and the likeness and sound of my voice as recorded on audio or videotape. (Please initial below)*

I understand that my image may be edited, copied, exhibited, published and/or distributed. I also understand this material may be used individually or in conjunction with other media in any medium, including without limitation to print publications, digital publications, and/or public broadcast for any lawful purpose. There is no time limit on the validity of this release nor are there any geographic limitations on where these materials may be distributed. (Please initial below)*

I waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, without payment or other consideration, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area. (Please initial below)*

By signing this release I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet on YouTube or other social media platforms.. (Please initial below)*

I will be consulted about the use of photographs or video recording for any purpose other than those listed above. (Please initial below)*

This release applies to photographic, audio or video recordings collected as part of the free session or sessions l am volunteering for. (Please initial below)*

By signing this release, I acknowledge that I completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against Rob Nelson or any person or organization utilizing this material for any purpose as stated above. (Please initial below) *

I agree that typing my name below is the electronic equivalent of my actual signature (Please initial below)*

Client signature and date*