Before & After Photo Contest

I, the undersigned, do hereby consent and agree that Valley Medical Weight Control & Valley Medical Weight Loss, its employees, or agents have the right use my photographs, now or hereafter known, and exclusively for the purpose use of Valley Medical Weight Control or Valley Medical Weight Loss of the following: website, clinic portfolio, clinic wall, television, medical, and/or print advertising. I further consent that my first name may be revealed therein or by descriptive text or commentary. I do hereby release to Valley Medical Weight Control and Valley Medical Weight Loss, its agents, and employees and its affiliates all rights to exhibit this work in print and electronic form for the sole use of Valley Medical Weight Control & Valley Medical Weight Loss. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback. By submitting my email address and telephone number I hereby agree to receive email correspondence and text messages which include special offers, our newsletter, and weight loss tips and tricks. Valley Medical Weight Loss will never sell or share my information. I represent that I am or have been a patient at Valley Medical in the last 12 months, at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.