Full Circle Doula Training Registration- Payment Option 2

I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration; I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears; waive any right to royalties or other compensation arising or related to the use of my image or recording.

I understand that I may be consulted about the use of the photographs or video recording for any purpose other than those listed above; that there is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. I understand this release applies to photographic, audio and/or video recordings collected as part of the sessions listed on this document only and by signing this form, I acknowledge that I have completely read and fully understand the aforementioned and agree to be bound thereby.

I understand that photographic, audio and/or video recordings may be used for the following purposes: conference presentations, educational presentations or courses, informational presentations, on-line educational courses and educational videos.

I understand that I will be consulted about the use of the photographs or video recording for any purpose other than those listed above and that there is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. I understand that this release applies to photographic, audio or video recordings collected as part of the sessions listed on this document only.

• If the training is canceled by SMC, the registrant (trainee) will receive a full refund.
• If the registrant (trainee) cancels within 24 hours from the time of registration, a refund will be given, less administrative fee of $50.00.
• If the registrant (trainee) cancels at least two weeks prior to the training start date, the registrant (trainee) has the option of transferring to another training of equal or lesser value within the program within 12 months of the original training date.