Submit your videos to win a trip to Miami Beach to be in our PBS special

Do you want to be in our PBS special? We are ready to film!  Let us know if you want to be considered to be in our PBS special on skin care and the skin typing system that will air in Dec. 2010. You will be flown to Miami Beach the week of July 6-10 2010 if you are chosen.  We will pay for hotel and air fare.  Approximately 6 people will be chosen.

Send us a video talking about your skin.  Here are some subject ideas:

1.Tell us about your skin issues

2. How much money do you spend on products?  Are you a product junkie?

3.  Has the typing system helped you? How?

4. Any other amusing stories about your skin, skin care products or your skin type?

5. Any experiences about the web site www.skintypesolutions.com that you want to share?

 

To submit your videos to be in the PBS special., please send us a video to

Leslie Baumann MD

Attn : Stephanie

Miami Heart Institute

7th floor

4701 N Meridian Ave

Miami Beach Fl 33140

305-532-5552

 

Don’t forget to give us your name, location (city and state), phone number and email so we can contact you.  Also please print out the consent form below and include it with your video.

 

We will be choosing the winners the week of June 21st, so please send these right away.  The actual video you send will probably not be used in the actual PBS special.  If we like your story in the video we would reshoot it here in Miami using HD technology.  In other words- the professionalism of the video is not as important as the actual story itself.  I look forward to seeing your videos!

 

Leslie Baumann MD

Come discuss at www.facebook.com/BaumannCosmetic

 

 

Print this and submit with your video:

 

Baumann Cosmetic & Research Institute

 

AUTHORIZATION FOR PHOTOGRAPHY AND/OR TAPING

 

 

I hereby authorize Baumann Cosmetic & Research Institute to take still photographs, videotapes and/or sound recordings of me.

 

I authorize Baumann Cosmetic & Research Institute to use in any manner said photographs, films, videos or tape recordings, in whole or in part:

 

[  ]    for any purpose whatsoever, including without limitations, all broadcast,  

promotional and advertising uses and other commercial purposes. (Please note that photos may be used for PBS Broadcast and/or YouTube videos).

 

 

I agree that Baumann Cosmetic & Research Institute, officers, employees, faculty and agents will not be responsible for any claims arising in any way out of the taking and use as described above of such photographs and/or recordings. I also understand that I will not have an opportunity to inspect and approve such photographs prior to their use.

 

 

 

 

 

__________________________                                __________________________

Patient’s Name Printed                                               Witness Name Printed

 

 

 

 

__________________________                                __________________________

Signature of Patient                                                    Signature of Witness

 

 

 

 

__________________________              __________________________

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