Name(Required) First Last Email(Required) Phone(Required)I HEREBY GRANT ANIMAL MEDICAL CLINIC, IT’S REPRESENTATIVES AND EMPLOYEES PERMISSION TO TAKE PHOTOGRAPHS OF MYSELF AND/OR MY PET, AND TO PUBLISH THOSE PHOTOGRAPHS FOR ANY LAWFUL PURPOSE, INCLUDING, BUT NOT LIMITED TO, THEIR WEBSITE, SOCIAL MEDIA ACCOUNTS, AND PROMOTIONAL MATERIALS, EITHER DIGITAL OR IN PRINT, IN PERPETUITY. I ALSO GRANT PERMISSION TO USE MY NAME AND/OR MY PET’S NAME. BY SIGNING AND DATING THIS DOCUMENT I AUTHORIZE ANIMAL MEDICAL CLINIC TO EDIT, ALTER, SHARE, REMIX, TWEAK, BUILD UPON OR IN ANY WAY ALTER THE PHOTOGRAPH(S) MENTIONED ABOVE. I ALSO WAIVE ANY RIGHTS OF PRIVACY OR COMPENSATION ASSOCIATED WITH THE USE OF MY OR MY PET’S IMAGES) AND NAME(S) FOR THE PERSONAL OR COMMERCIAL PURPOSES OUTLINED ABOVE.(Required) Accept Do Not AcceptCAPTCHAΔ
