OsteoStrong | Member Release Form

OsteoStrong Australia centres regularly take photos and video in centre for use on social media, our website and promotional purposes. Where a testimonial or success story has been shared with us by a member, we will only ever use first names, and home centre. No other identifying data will be shared.

Please complete the form below to give your permission for your likeness to be used in this way. You may withdraw this permission at any time by emailing your home centre.

Member Name *

Email Address *A copy of your submission will be sent to this address

Phone *

Which centre do you regularly attend? *

Signature *I hereby grant to OsteoStrong Australia the absolute and irrevocable right and unrestricted permission to use my name, likeness, image, video, voice, testimonial, and/or appearance as such may be embodied in any photos, video recordings, audiotapes, digital images, and the like, taken or made on behalf of OsteoStrong Australia or its partners. I agree that OsteoStrong Australia has complete ownership of such material and can use said material for any purpose consistent with OsteoStrong Australia’s business. These uses include, but are not limited to, videos, publications, advertisements, news releases, websites, and any promotional or educational materials in any medium. OsteoStrong Australia shall have the right to modify, reproduce, display or otherwise disseminate my photos / videos, in whole or part, provided that any modifications or alterations made do not significantly alter or misrepresent the original content. I acknowledge that I will not receive any compensation for the use of such images, videos, likeness etc. I warrant and represent that this release does not in any way conflict with any existing commitment on my part. Nothing herein shall constitute an obligation on OsteoStrong Australia to make use of any of the rights set forth herein. I hereby release and discharge OsteoStrong Australia, and its agents, representatives and assignees from any and all claims and demands arising out of or in connection with the use of my name, likeness, image, voice, and/or appearance, including but not limited to, any and all claims for invasion of privacy, right or publicity, misappropriation or misuse of an image, and/or defamation. This authorization also shall extend to those persons, firms, organizations, corporations, associations, or entities participating in the taking of such photographs and/or the filming. I represent that I am over the age of eighteen (18) years and that I have read the foregoing and fully understand the contents.* This release shall be binding upon me, my heirs, legal representatives, and assigns. This agreement embodies the entire agreement of the parties (subject and photographer). No modification of this agreement shall be of any effect unless it is made in writing and signed by all parties to the agreement. *If the person signing is under the age of 18, consent from a parent or guardian is needed. I hereby certify that I am the parent or legal guardian of, named above, and do hereby give my consent without reservation to the foregoing on behalf of this individual.

Publicity and Photo / Video

Publicity and Photo / Video

Member Release Form