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Testimonial Release and Authorization

I hereby give my written permission to Shaya Wellness, LLC to use my testimonial (the “Testimonial”), in part or in full, without any consideration paid to me.  I understand that the Testimonial is made on behalf of Shaya Wellness, LLC and that it may use the Testimonial in connection with publicizing and promoting Shaya Wellness, LLC.  I authorize Shaya Wellness, LLC to use the Testimonial and my name or initials, whichever is my preference.  If I prefer to have only my initials used in conjunction with the Testimonial, then Shaya Wellness, LLC shall not be authorized to use my full name.

I hereby irrevocably authorize Shaya Wellness, LLC to copy, exhibit, publish or distribute the Testimonial, in part or in full, for purposes of publicizing its services, programs, products, or for any other lawful purpose.  I agree that Shaya Wellness, LLC shall be the owner of the copyright in and to the Testimonial and that the Testimonial may be used in printed publications, multimedia presentations, on websites or in any other distribution media. Further, I agree that I will make no monetary or other claim against Shaya Wellness, LLC for the use of the Testimonial.  

I hereby hold harmless and release Shaya Wellness, LLC from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this Testimonial Release & Authorization.

By filling out the form below and submitting my testimonial I acknowledge that I have read this Testimonial Release & Authorization and give my consent for the use of the Testimonial in accordance with the terms and conditions set forth above.