Media Release Form
Media Release Form
$25.00
I, _____________________, grant permission to ADD YOUR COMPANY INFORMATION HERE
hereinafter known as the “Media” to use my image (photographs and/or video) for use in
Media publications including:
Institute for Optimal Healing & Aesthetics
Helping You Achieve Optimal Health Inside and Out
$25.00
I, _____________________, grant permission to ADD YOUR COMPANY INFORMATION HERE
hereinafter known as the “Media” to use my image (photographs and/or video) for use in
Media publications including:
