Janna Hasbrouck
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Release Form for
Coffee Break Coaching
Reminder: hit the submit button at the bottom to complete your form!
I, the undersigned, hereby grant and authorize Janna Hasbrouck of Living Without Limits LLC, the right to take, edit, alter, copy, exhibit, publish, distribute and make use of any and all video taken of me to be used in and/or for any lawful purpose. This authorization extends to all languages, media, formats and markets now known or later discovered. This authorization shall continue indefinitely, unless I otherwise revoke this authorization in writing. I waive the right to inspect or approve any finished product in which my likeness appears. I agree that I have been compensated for this use of my likeness or have otherwise agreed to this release without being compensated. I waive any right to royalties or other compensation arising or related to the use of the video. I understand and agree that these materials shall become the property of Living Without Limits LLC and will not be returned. I hereby hold harmless and release Living Without Limits LLC from all liability, petitions, and causes of action which I, my heirs, representative, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my estate. Check below:
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I have read and understand.
In addition, I understand that this video session is not intended to be, nor is it a replacement for, therapy. Check below:
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Yes, I understand
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