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Individual Liability Release

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Do you consent and authorize Fellowship Hall to use your testimonial as described below:
If you selected "Yes, I consent" you authorize Fellowship Hall to use and reproduce your testimonial, name, voice, and/or likeness in any manner, form or way relating to marketing, promotion, and social media. You hereby release Fellowship Hall, its employees, agents, subsidiaries, affiliates and assignees from any and all claims, actions, and liabilities related to and in any way connected with the use of your name, voice and/or likeness, and statements as hereinbefore authorized.
Waiver regarding use of your image:*
By selecting "Yes, I understand..." I understand that my image may be edited, copied, exhibited, published or distributed and I waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.
Waiver regarding use of video or audio featuring you:*
Audio or video recordings may be used for television, radio, print or on-line usage for the purpose of advertising and promotion, as well as education. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. This release applies to audio and video recordings collected for us on Fellowship Hall's social media pages, brochures, website, printed newsletter and/or advertisements.
By providing my name and contact information below, I hereby release any and all claims against any person or organization utilizing this material for promotional or educational purposes where I consented my material may be used. If I selected "no," I understand that my material will not be used for promotional or educational purposes.
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Admissions
336-553-6596
Office
(336) 621-3381

ACCREDITED BY THE JOINT COMMISSION

Recognized nationwide as a symbol of quality reflecting an organization’s commitment to meeting high standards of healthcare service delivery, providing cost-effective, best-value care.

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Fellowship Hall is honored to welcome guests from NC, SC, VA, TN, and across the United States. We do not discriminate because of race, gender, sexual orientation, socioeconomic status, religion, national origin, or disability. We are an adult only program, accepting guests 18 years of age and up.
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