Testimonial Agreement

Tacha Kasper, Healing Point Counseling / Resilient Life Institute LLC

Updated December 1, 2020

The person indicated in the digital form voluntarily agrees to the following: 

(1) I voluntarily authorize the use of my name and likeness, together with my endorsement or testimonial, whether written or oral, which may appear in any media released by Healing Point Counseling / Resilient Life Institute LLC collectively, it agents, representatives and/or assignees, in connection with any advertisement or promotion of Healing Point Counseling / Resilient Life Institute LLC products and or services. 

(2) I understand that [please choose one]

• My testimonial will be disclosed as: name, (Gender Male or Female), Age, Location, (and title and company name if applicable)  will be disclosed in conjunction with my testimonial or endorsement,                                          Example: John Doe, Male, 47, Huntington Beach, California
  

OR

• My testimonial will be disclosed as “Satisfied Customer, (gender Male or Female), Age, Location”, or                                                                         Example: Satisfied Customer, Male, 47, Huntington Beach, California

OR

• My testimonial will be disclosed as: __________________________________
  

(3) I agree that Healing Point Counseling / Resilient Life Institute LLC may copyright my endorsement or testimonial in its name or any other name it may choose. 

(4) I authorize Healing Point Counseling / Resilient Life Institute LLC and/or its agents, representatives, and assignees to use, reproduce, exhibit and distribute any promotional materials containing my name and likeness, together with my endorsement or testimonial, for the purpose of endorsing its products and/or services. 

(5) I agree that Healing Point Counseling / Resilient Life Institute LLC and/or its representatives, agents, or assignees own all rights, including the copyright in and to any videos, still photographs, and any other material made by Healing Point Counseling / Resilient Life Institute LLC or its representatives, agents, and/or assignees, which contains my name, likeness, endorsement, or testimonial. 

(6) I hereby waive any right to inspect or approve the finished video, soundtrack, ad copy, printed or electronic matter that may be used. 

(7) I agree that my testimonial may be used by Healing Point Counseling / Resilient Life Institute LLC starting from the date listed below and extending as long as the business exists, unless I request otherwise. 

(8) I hereby certify that my endorsement or testimonial of Healing Point Counseling / Resilient Life Institute LLC service(s) and product(s) is true and accurate and reflect(s) my personal experience and honest belief in the quality of the service(s) and product(s) that I am endorsing. I am doing this testimonial of my own free will and I have not been paid a monetary sum for doing so. 

(9) I hereby certify that I am over twenty-one years of age and competent to contract in my own name. 

(10) I understand that this Testimonial Release Form may not be amended without my written consent and the written consent of Healing Point Counseling / Resilient Life Institute LLC.

(11) I have read the foregoing Testimonial Release Form before signing my name and warrant that I fully understand its contents and I am signing it voluntarily. 

(12) I hereby release Healing Point Counseling / Resilient Life Institute LLC and its officers, employees, board of directors, and agents from any and all claims and damages arising out of or in connection with the use of my endorsement including any photographs, videos, soundtracks or ad copy.