Talent Authorization

We are dedicated to sharing our journey and the incredible stories of growth and resilience within our community. To do this, we often capture and share images and videos that highlight the transformative experiences of our staff, clients, and their families. By participating, you help us inspire others and showcase the impactful work we do together. This Talent Release Form ensures that we respect and protect your privacy and rights in using these images and videos across our marketing platforms. We do not sell or share your information with any third party outside of this use. We appreciate your support and willingness to be part of our shared mission.

Talent Authorization

Talent Release

Video and Photo Release

Growing Healthy Children Therapy Services, Inc. DBA Growing Healthy Seasons is an educational organization. As such, we may video or photograph individuals participating in treatment, evaluation, or research projects, to ensure highest quality of care. The video and photos may include interviews, assessments, treatments, or group activities, and will be accessible only to your/your child’s treatment team at GHC. The rights, titles, and interests of these materials belong to Growing Healthy Children Therapy Services, Inc., DBA Growing Healthy Seasons, which reserves the right to edit the material.

In addition, I voluntarily consent to the taking of photographs or video of myself and/or my child, for the following additional purposes:

Please select your permissions:

for educational purposes, scientific purposes, for media purposes in educational training programs and/or publications and/or medical/scientific programs and/or publications. The rights, titles and interests of these materials belong to Growing Healthy Children Therapy Services, Inc. DBA Growing Healthy Seasons, which reserves the right to edit the material.

to be added to the Growing Healthy Seasons website, newsletter, social media accounts, or event promotional materials. The rights, titles and interests of these materials belong to Growing Healthy Children Therapy Services, Inc. DBA Growing Healthy Seasons, which reserves the right to edit the material.

I decline permission for photos or videos to be shared outside of my/my child’s treatment team.

Name

First

Last

Phone

I am signing for:

Myself

My underage child

Child's Name

Child's DOB

I am a GHS Employee/Contractor

Yes, I work for GHS at the moment of signing.

No, I am not an employee or contractor for GHS at the moment of signing.

I understand I will not be compensated by any party. Although photographs and/or video images shared outside my/my child’s treatment team will be used without identifying information such as name, I understand someone may recognize me.

I further acknowledge by consenting to this, I agree that the use of any photographs and/or video images confers no rights of ownership or royalties whatsoever.

I hereby release Growing Healthy Seasons, its employees, and any third parties involved in the creation of or publication of educational or marketing materials, from liability for any claims by me or any third party in connection with my participation.

By signing this form, I confirm my understanding of this consent. If I wish to withdraw my consent in the future, I may do so via a written request submitted to Growing Healthy Seasons or by completion of a new form.

Signature

Clear

Date

Captcha

Talent Authorization

Talent Authorization

Video and Photo Release

Title