Zengar^® Authorization & Release Statement

TESTIMONIAL Authorization and Release

I am at least 18 years of age and authorize Zengar Institute Inc. (herein “Zengar^®”) to use my photo image, video or testimonial (written or recorded) and the biographical information I provide (the “Testimonial”) in connection with publicizing and promoting the NeurOptimal^® system, as described below.

By clicking YES, I am granting Zengar Institute, Inc. permission to use my Testimonial (INCLUDES: photo image, video, written or recorded testimony), as follows:

CONSENT: I acknowledge that my Testimonial may be published and made public. I give to Zengar^® my permission to use my Testimonial in communications, marketing materials, and social media, on a worldwide basis, for such time as Zengar^® may wish to use it. I understand that Zengar® may use my Testimonial on their website, in print advertising and printed marketing materials, in electronic marketing materials that are published on-line, in their social media posts, promotions, and communications (for example and not limitation, platforms like Facebook, Twitter, MailChimp, Constant Contact, and Instagram; and, in videos posted on YouTube; in narrations read by an actor portrayal; and, by reference in conversations with clients and prospective clients.) I give Zengar^® permission to excerpt and use portions of my Testimonial and translate it into other languages.

I understand that I may revoke my consent at any time by contacting Zengar^® in writing, as described below. I understand and agree that I will not be paid for use of this Testimonial and agree that in the future I will make no claim for compensation from Zengar^® for use of my Testimonial. I hereby hold harmless and release Zengar^® from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. In revoking my consent, I do not and will not in the future require Zengar^® to replace or destroy existing printed materials or video that has the Testimonial embedded within the media, although no further future printed materials or video media will be made that include the Testimonial.

HOW TO REVOKE YOUR PERMISSION: The person providing their Testimonial can revoke their permission granted to Zengar^® at any time. Contact Zengar^® in writing (email is OK), and include in your message a link, screenshot or description identifying where the Testimonial is being used so we can find it and remove it expediently. If you do not receive an acknowledgment from us within five (5) business days, please telephone us to confirm we received your message. Once we confirm receipt, please allow us up to five days to handle your request, and telephone us again if you continue to see the testimonial that you want removed since it is sometimes the case that a Testimonial appears in multiple locations.