Spiritual Guidance for the Badass Butterfly Pre-Session Worksheet and Release Form

Please complete the information below as thoroughly as you can.  Please note that all Spiritual Guidance for the Badass Butterfly Sessions are LIVE and PUBLIC. If you do not want your image shown during the session, then you can join the session with your video turned off. If you do not want your name used during the session, then join with either just your first name or give a pseudonym (a false name.) During the session we will be referring to you by whatever name you indicate IN THIS FORM and the session login. After submitting this form, a copy will go to Crystal Lynn for review and you will also receive a copy in your inbox.  If you have any questions about any part of the form, please email CrystalLynn@Spiritcentric.com.

  • Participant Information

  • MM slash DD slash YYYY
  • Release Agreement

    Please read and sign the Release Agreement below.
  • RELEASE AGREEMENT Whereas, Crystal Lynn Bell (the "Producer") is engaged in a project (the "Video"), and Whereas, I, the undersigned, have agreed to appear in the Emotional Wellness Happy Hour group coaching and healing circle Video, and Whereas, I understand that my voice, name, and image will be recorded by various mechanical and electrical means of all descriptions (such recordings, any piece thereof, the contents therein and all reproductions thereof, along with the utilization of my name, shall be collectively referred to herein as the "Released Subject Matter"), Therefore, in exchange for $0.00, receipt of which is hereby acknowledged and whose sufficiency as consideration I affirm, I hereby freely and without restraint consent to and give unto the Producer and its agents or assigns or anyone authorized by the Producer, (collectively referred to herein as the "Releasees") the unrestrained right in perpetuity to own, utilize, or alter the Released Subject Matter, in any manner the Releasees may see fit and for any purpose whatsoever, all of the foregoing to be without limitation of any kind. Without limiting the generality of the foregoing, I hereby authorize the Releasees and grant unto them the unrestrained rights to utilize the Released Subject Matter in connection with the Video's advertising, publicity, public displays, and exhibitions. I hereby stipulate that the Released Subject Matter is the property of the Producer to do with as it will. I hereby waive to the fullest extent that I may lawfully do so, any causes of action in law or equity I may have or may hereafter acquire against the Releasees or any of them for libel, slander, invasion of privacy, copyright or trademark violation, right of publicity, or false light arising out of or in connection with the utilization by the Releasees or another of the Released Subject Matter. It is my intention that the above mentioned consideration represents the sole compensation that I am entitled to receive in connection with any and all usages of the Released Subject Matter. I expressly stipulate that the Releasees may utilize the Released Subject Matter or not as they choose in their sole discretion without affecting the validity of this Release. This Release shall be governed by California law. I hereby certify that I am over the age of eighteen, and that I have read, understood, and agreed to the foregoing.
  • Please sign in the box above and then hit Submit.

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Copyright

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