Model Release Agreement Please complete the form below * I grant permission to Yuka Sugiura and LevelUp Bodywork to use my image (photographs and/or video) for promotional purposes, on websites and social media. I understand that all photographs and videos are property of Yuka Sugiura and LevelUp Bodywork and can be used for promotional purposes, on websites and social media without compensation. By participating in this program, I consent to photographs, videos, and/or audio recordings that may be made that contain my image, voice and/or likeness. Name * First Name Last Name Guardian (if client is under 18) First Name Last Name Date * MM DD YYYY Thank you! I’m looking forward to working with you.