Leave a Testimonial

Your words can inspire others! Please leave a testimonial with your
experience of our programs or services. Thank you!

Name

First Name

Last Name

Email

Credentials/Titles (if none, please write N/A)

My Testimonial

Please use:

My full name and credentials/titles (e.g., Jane Smith, RN)

My first and last name only (e.g., Jane Smith)

My first name and last name initial only (e.g., Jane S.)

I will provide a photograph that may be used with my Testimonial:

Yes

No

Testimonial Release & Authorization

I hereby give my written permission to The Practical Path, Inc. ("TPP") to use my testimonial (the “Testimonial”), in part or in full (and/or my photographic likeness if I choose to provide it) without any consideration paid to me. I understand that the Testimonial is made on behalf of TPP and that it may use the Testimonial in connection with publicizing and promoting TPP programs or services. I authorize TPP to use the Testimonial and my name preference as indicated above. If I prefer to have only my first name and last name initial used in conjunction with the Testimonial, then TPP shall not be authorized to use my full name. I hereby irrevocably authorize TPP to copy, exhibit, publish, reproduce, distribute, or disclose the Testimonial, in part or in full, for purposes of publicizing its programs, services, or for any other lawful purpose. I agree that TPP shall be the owner of the copyright in and to the Testimonial and that the Testimonial may be used in printed publications, multimedia presentations, on websites or in any other distribution media, in perpetuity throughout the world. Further, I agree that I will make no monetary or other claim against TPP for the use of the Testimonial, nor will I have any input concerning the use of the Testimonial. TPP shall have the right to edit any written information that I provide for the Testimonial. I hereby hold harmless and release TPP, its officers, board members, employees, consultants, volunteers, and others associated with TPP from all claims, demands, and causes of action of whatsoever kind or nature, 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 Testimonial (and/or my photographic likeness if provided). I acknowledge that I have read and understood the above Release and give my consent for the use of the Testimonial in accordance with the terms and conditions set forth above. First and Last Name:

Typing your name in the field provided above will be considered your signature and constitute your acceptance and agreement to this Testimonial & Release Authorization. This Testimonial & Release Authorization becomes effective as of the date of this submission.