Photo Release Form

Please fill out the photo release form for Pearson Chiropractic & Rehabilitation Center. Stay Active Live Healthy!

I, ___(Name Stated Above)___ grant permission for Pearson Chiropractic & Rehabilitation and Trulson + Tews and their agents and employees the irrevocable and unrestricted right to reproduce, edit, copy, change and make use of any and all photographs or video of me taken in connection with Pearson Chiropractic & Rehabilitation to be used for promotional materials. I acknowledge that I will not be entitled to payment or any sort of charge for such action. I authorize the use of photographs or video of myself for, but not limited to, publication on the internet, magazines, articles, brochures, posters, flyers and other promotional materials, etc., provided that it is done for lawful purposes. Upon the usage of my photographs or video, I consent to such materials becoming the sole property of Pearson Chiropractic & Rehabilitation, and I will no longer be entitled to them, provided that it is done for lawful purposes. I release all rights to any, but not limited to, claims, rights, demands and/or any causes of action by me or my representatives, heirs or anyone else. Furthermore, I waive my right to any royalty or any other compensation with regard to the usage of the photos or video referred to in this form.