Mindful Physician Small Group Course Registration

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Without expectation of compensation or other remuneration, now or in the future, I hereby give my consent to Awaken Breath, LLC, its affiliates and agents, to use my image and likeness and/or any interview statements, during video sessions of me in its online library, links to videos made only available to current same-course participants of the Mindful Physician Course. This consent is given for one year beyond the duration of the course, and does not require prior approval by me.
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