Yes, you did!

1) That it is hereby agreed that I, a patient of Dr. Bernstein Diet & Health Clinics, have agreed to provide a series of photographs and/or video that demonstrates my weight loss over a specified period of time, and/or to provide written or verbal statements about my diet and weight loss experiences, in addition to clinical data associated with my weight loss.

2) It is agreed that the Patient authorizes Dr. Bernstein Diet & Health Clinics to use the photos, video, statements and data in external and internal promotional materials including but not limited to television commercials, infomercials, radio ads, website and internet advertising, and other out-of-home media.

3) It is agreed that in consideration for the unlimited use of the photos and statements in the advertising and promotional materials, any fees for services paid by the Patient to Dr. Bernstein Diet & Health Clinics will be refunded. And as long as the Patient maintains his/her weight at or near the recommended goal weight, and his/her attendance is regular, all continued treatment on The Maintenance Program by Dr. Bernstein Diet & Health Clinics will be rendered free of charge.

4) Refund payment will be made upon receipt of all requested materials including photos and/or statements.

5) The advertising and promotional materials created by or on behalf of Dr. Bernstein Diet & Health Clinics will present the Patient in a positive manner for the purposes of demonstrating healthy weight loss results. The Patient agrees to and undertakes to never speak disparagingly of Dr. Bernstein and the Dr. Bernstein Diet & Health Clinics and their weight loss programs.

6) This agreement is governed by the laws of Ontario and can only be altered by written consent of both parties.