By submitting this form, I represent that I am over the age of 18 years old and that I am the owner of any intellectual property contained in or comprising my photo, testimonial, name and/or that I have the express permission or a license to use the intellectual property contained in or comprising my photos, images and testimonials, which include my “Story” and my “Results” (“Submissions”).

I understand that Simple Green Smoothies, LLC (“Simple Green Smoothies”) may use my name and/or Submissions in and on the Simple Green Smoothies and Rawk the Year website and social media properties. My Submission may be used in courses, programs, published books, eBooks, advertising and promotional material related to Rawk the Year.

I hereby authorize Simple Green Smoothies to use my Submissions without any form of compensation.