Waiver Form | Breakthrough Fitness | Austin, TX
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Zumba Fitness ATX in Austin, Texas

Photo & Video Release Form

I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or  video tape without payment or any other consideration. I understand that my image may be edited, copied,  exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my  likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the  use of my image or recording. I also understand that this material may be used in diverse educational  settings within an unrestricted geographic area.  

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Photographic, audio or video recordings may be used for the following purposes: 

• conference presentations 

• educational presentations or courses 

• informational presentations 

• on-line educational courses 

• educational videos 

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By signing this release I understand this permission signifies that photographic or video recordings of me  may be electronically displayed via the Internet or in the public educational setting.  

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I will be consulted about the use of the photographs or video recording for any purpose other than those  listed above. 

There is no time limit on the validity of this release nor is there any geographic limitation on where these  materials may be distributed. 

This release applies to photographic, audio or video recordings collected as part of the sessions listed on this  document only. 

By signing this form I acknowledge that I have completely read and fully understand the above release and  agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing  this material for educational purposes.

Thanks for submitting!

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