Video Release - PEMF IT Cedar Park TX

Video Release Form

I hereby authorize PEMF IT and its affiliated companies to videotape, photograph, record and to publish in any media or format, myself, my name, qualifications, opinions and any material/information that I choose to offer, bring or submit to them now and in the future (hereinafter “Material”) for the purpose of educating and promoting pulsed electromagnetic field use and PEMF IT ’s services or for other purposes that PEMF IT may determine appropriate.

I hereby acknowledge and understand that products are not medical devices and are not designed nor sold for the purpose of diagnosing or treating medical diagnoses or disease. Any experiences or opinions that I may share with PEMF IT are my own. I undertake full responsibility for any opinions and all information expressed by me and release, absolve and hold PEMF IT harmless from any consequence that may result from them.

I unconditionally and for all time enter into this “Permission & Release” in exchange for the opportunity to tell my story and help other people. I hereby waive the right to receive any other payment for entering into this permission/release and waive the right to receive any further payment for PEMF IT’s use of any of my Material. I also waive any right to inspect or approve finished images, recordings or media in any form that may be used in conjunction therewith or to approve the use, if any. I irrevocably grant the right to capture, modify, edit, reproduce, commingle, sell and otherwise use without limitation any voice, image, phrase, experience, information, sound or other expression or appearance that I demonstrate to PEMF IT for the purposes noted above as it deems fit in PEMF IT’s sole discretion, and convey all ownership in the same. I understand that this Permission/Release includes voice or utterances in all languages, images or other characteristics that I may express in any current (e.g.; internet, broadcast, advertising and twitter) and future developed media forms including hearings, and give it freely and voluntarily for all markets.

I HAVE READ AND FULLY UNDERSTAND THE TERMS AND CONDITIONS OF THIS PERMISSION & RELEASE AGREEMENT, AND KNOW, AGREE AND COMMIT TO IT BEING LEGALLY BINDING ON MYSELF, MY BUSINESS, MY HEIRS AND ASSIGNS.

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Informed Consent Agreement *

Yes, I understand the information and agree with the terms contained within this document. Yes, I agree that by typing my Full Name above and clicking on the “Submit” button below I am electronically signing this document.

Beyond what is stated above, I understand that other risks associated with a pulsed magnetic exercise session are unforeseeable and that the demonstrator, the manufacturer, the marketer, employees, agents and affiliates shall not accept any liability for loss or damages incurred as the result of the Pulse PEMF System session. I reserve the right to use the knowledge I have gained in the care of my own body in any legal manner I shall choose. I have read this form and voluntarily agree to the Pulse PEMF System sessions and accessories on my person assuming all liability for any and all results or consequences.

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