Consent Form:

I hereby grant Equilibrium in Mind and Body permission to use the above comments in whole or in part for promoting and advertising the products or services they provide. I authorise Equilibrium in Mind and Body to use my first initial and surname (J. Bloggs), or I understand I can remain anonymous (by selecting the appropriate tick box below), brief biographical information (e.g. Glasgow, Scotland), and the Testimonial as defined on this form. I authorise Equilibrium in Mind and Body, to copy, exhibit, publish or distribute this testimonial for purposes of publicising Equilibrium in Body and Mind’s services or for any other lawful purpose.

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The testimonial statement(s) may be used in printed publications, multimedia presentations, on websites, or in any other distribution media including social media. I agree that I will make no monetary or other claim against the company for the use of the statement. In addition, I waive any right to inspect or approve the finished product, including written copy, wherein my testimonial appears.

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I understand that signing this consent form is voluntary. I am at least 18 years of age and am competent to contract in my own name.