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Video TestimoniaL SUBMISSION

Please consider the following:

1. “I lost X amount of pounds in Y amount of months with the help of the Doctor’s Diet Program and you can too!”
2. Submit with First and Last Name
3. Record in landscape format.
4. Record in a well lit area.

Ready to submit?

By submitting video I understand my testimonial as outlined above or in the video recorded of me (the “Testimonial”) and made on behalf of Doctor’s Diet Program (hereinafter called “The Business”) may be used in connection with publicizing and promoting Doctor’s Diet Program. I authorize Doctor’s Diet Program to use my name, brief biographical information, and the Testimonial as defined on this form or by me in this video.
I hereby irrevocably authorize Doctor’s Diet Program to copy, exhibit, publish or distribute the Testimonial for purposes of publicizing The Business’ programs or for any other lawful purpose. These statements may be used in printed publications, multimedia presentations, on websites or in any other distribution media. I agree that I will make no monetary or other claim against Doctor’s Diet Program for the use of the statement.
In addition, I waive any right to inspect or approve the finished product, including written copy or edited video wherein my likeness or my testimonial appears.
I hereby hold harmless and release The Business from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.