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Nurturing Families Program
Contact Information
Name
*
First Name
Last Name
Phone
*
Email
*
Verify Email
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Address
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Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Referring Agency
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Case Manager's Name
*
First Name
Last Name
Client Testimony/Photo Authorization and Release
*
I understand that my testimony, made on behalf of Truly Valued, Inc., may be used in connection with marketing, publicizing and promoting Truly Valued, Inc. and my testimony will become the sole and exclusive property of Truly Valued, Inc. I authorize Truly Valued, Inc. to use my name, photograph, biographical information and testimonial for Truly Valued Inc. I grant Truly Valued, Inc., its representatives and employees the right to use my name, photograph, biographical information, and the testimonial in various marketing initiatives. I understand that this information may be used in various mediums for such purposes as publicity, illustration, advertising and Web content. I authorize Truly Valued, Inc. to copyright, modify, use, sell, and publish these materials in both print and electronic formats for purposes of publicizing Truly Valued, Inc. In addition, I waive any right to inspect or approve the finished product wherein my likeness or my testimony appears. I agree that I will make no monetary or other claim against Truly Valued, Inc. for the use of my name, photograph, biographical information and testimonial. I have read, understand and agree to the above.
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