Testimonial & Photo Release Form

Instructions: Please read the release form. Then complete your testimonial, consent, and click submit. Thank you!

RELEASE FORM:

Testimonial and Photo Release:

I hereby consent to authorize the use of testimonials I have made, for use by Bellantz® LLC, its employees, and the right to copyright and/or use, reuse and/or publish, republish testimonials, in conjunction with my full name or agreed upon abbreviation or initials.

I also give permission for the photographs, digital images or testimonials be used in their entirety as agreed upon by me and Bellantz® LLC., including the use of images on the Bellantz® website.

Furthermore, permission is also given for the photographs, digital images or testimonials, to be used by Bellantz® at any time in the future without further clearance from me.

I understand that these photographs, digital images or testimonials, may be used for marketing purposes only (including websites) by Bellantz® LLC.

I have read the foregoing release, authorization and agreement, before completing the consent form below, and warrant that I fully understand the contents thereof.

CONSENT: