Media Release Waiver

This form is to allow/deny consent of God's Healing Hands Massage Services to take still photos, moving photos, as well as videos; and to post them to social media accounts for advertising purposes.

First name

Last name

I agree to allow God's Healing Hands to take pictures/recordings of my service and to post them to social media.

I consent

I DO NOT consent

Date

Month

Day

Year

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.