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Terms & Conditions for Receiving a Complimentary Session 

This form is separate from the Terms & Conditions. Select only the permissions you want to grant. Unless BELLAMADRE clearly states otherwise before enrollment, declining these permissions will not affect an otherwise approved complimentary session. 

A. Scope of permission. 

If you select YES, you grant BELLAMADRE a non-exclusive, royalty-free permission to use the selected material for the purposes described above. BELLAMADRE may crop, resize, caption, or make reasonable technical edits, but should not materially misrepresent your words or experience. 

 

B. No payment. 

You understand that you will not receive payment or royalties for authorized use of the selected materials unless BELLAMADRE separately agrees in writing. 

 

C. Withdrawal for future use. 

You may withdraw consent for future uses by contacting BELLAMADRE in writing at bellamadrecorp@gmail.com. Withdrawal will apply prospectively. BELLAMADRE may not be able to retrieve copies already printed, distributed, reposted by others, archived, or incorporated into materials already released before withdrawal. 

 

D. No transfer of ownership of your underlying story. You retain ownership of your original story and other material you create, subject to the permissions you grant above.

I permit BELLAMADRE to photograph or record me before, during, or after my session and to use approved images/video for BELLAMADRE's website, social media, newsletters, fundraising materials, media outreach, and nonprofit promotional materials.
YES
NO Photo/Video Consent
I permit BELLAMADRE to publish all or selected excerpts of the story or written information I voluntarily submit, with reasonable edits for length and clarity that do not materially change the meaning.
YES
NO Story Consent
I permit BELLAMADRE to publish a voluntary statement or testimonial I provide about my experience.
YES
NO Testimonial Consent
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