Barbershop Conversations Training Registration

Confess Project Barber Shop Training Registration Form

First Name

Last Name

Birth Date

Gender

Ethnicity

Race

Barbershop Address

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone Number

Barbershop Name

Education Level

Professional Type

Courses

I hereby grant EnVision Resolution, its partners, and affiliates the right to record, photograph, and use my name, voice, image, and likeness for use in any media, including but not limited to video, print, and digital platforms, in connection with Barbershop Conversations.

I understand this content may be used for promotional, educational, and public awareness purposes. I waive the right to inspect or approve the final materials and understand I will receive no compensation.

I release EnVision Resolution and its representatives from all claims arising from the use of this material.

Do you give Envision Resolution Consent?

Yes

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