Photo, Video, and Social Media Release Form Thank you for choosing Rocky Gorge Resort & Spa for your pet’s care. Please complete the following form ahead of your pet’s appointment. Your cooperation is appreciated! Pet Parent Name* First Last Pet's Name* Primary Phone Number*Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Consent of Pet Parent* I hereby grant my consent to use photographs and/or videos of myself and/or my pet in the facility and/or on social media sites associated with Rocky Gorge Animal Hospital, Resort and Spa. If given, testimonials can also be used by Rocky Gorge.Today's Date* MM slash DD slash YYYY