Generosity of Scars Sign Up – Topeka, KS

Is there anything you'd like us to be aware of prior to your attendance at the workshop?

General Media Release Form:

The following Media Release Form is effective the date of submission of the Workshop Sign Up Form. I, the undersigned (the "party"), acknowledge and agree to the terms below:

1. The party grants permission to The Heroes Journey to record their likeness, image, voice, interview and performance to be used in The Heroes Journey publications, both print and digital forms, including but not limited to the company's website, newsletters, emails, videos, social media posts, brochures, and advertisements.

2. The party grants The Heroes Journey creative permission to alter their likeness, image, voice, interview and performance, permitted that these are not altered in an explicit manner or cause malicious representation of the party and their associates.

3. The party consents any third party (including any agency, client, publication or other organization or institution) in whole or in part, for distribution ("sharing") of their likeness, image, voice, interview and performance on their social media accounts, for the purposes of publicity and promotion of The Heroes Journey.

4. In giving this consent, the party releases The Heroes Journey from liability for any violation of any personal or proprietary right the party may have in connection with all third parties' use of their likeness, image, voice, interview and performance on social media.

5. In giving this consent, the party agrees that there will be no financial or other remuneration for using their likeness, image, voice, interview and performance The party also consents that their name and identity may be revealed in the descriptive text or commentary.

6. The party understands that this material also may be used in diverse settings within an unrestricted geographic area.

7. The party certifies that they are 18 years of age or older. If the party is not 18 years of age or older, they must have a parent's permission to sign below.

Read the options and check what type of permission you would like to give The Heroes Journey in regards to your photos, videos, stories, etc.

The Heroes Journey is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. If you consent to us contacting you for this purpose, please agree by clicking the box below.

You may unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.

By clicking submit below, you consent to allow The Heroes Journey to store and process the personal information submitted in this form to provide you the content requested.

Please type your full name - Digital Signature