2025 Annual ZBHA Photo Release Form

Page 1 of 1     Annual Photo Release Form   Students of Zero Balancing classes only need to complete ONE (1) Photo Release Form each year, even if they take multiple classes. Your answer on this form will be extended to any class you take in 2025, online or in-person. If you would like to change your answer for any specific class, please reach out to the ZBHA office.     We ask all attendees of Zero Balancing Health Association (ZBHA) sponsored classes and events to give written consent to the ZBHA, the Zero Balancing Touch Foundation (ZBTF), as well as Faculty and class participants to reproduce images from the class. Class participants may not upload images taken at the event to social media or other formats without consent of those in attendance. Such permission also grants Zero Balancing organizations and ZBHA faculty members the right to use all such digital images without payment or further consent from individual students. Please indicate on this form whether you give permission or do not give permission.       1. Your Name:*         2. Your email address:*           I grant to Zero Balancing Health Association (ZBHA), the Zero Balancing Touch Foundation (ZBTF), as well as Faculty and class participants in connection with the above-identified event, the right to take photographs of me. I authorize the ZBHA, the ZBTF, its assignees and transferees the right to copyright, use and publish the same in print and/or electronically. I agree that ZBHA and the ZBTF may use such photographs of me with or without my name and for any lawful purpose, including, for example, publicity, illustration, advertising, and website content. I understand that a preview of photos prior to use is not possible. Photo(s) use is at the express discretion of the ZBHA and/or ZBTF.       3. By selecting "Yes" I am agreeing to the above statement. By selecting "No", I indicate that I am not agreeing to the above and withhold permission to reproduce my image.* Yes No   Yes No       4. Date:*         5. By typing your name below, you're certifying an electronic signature (including parent or guardian (if under age 18):*