I,_____________________________, hereby affirm, represent, and attest to the fact that the following identified
(full name of witness)
photograph of ______________________________was taken on ______________ and is a representative
(name of contestant)
(insert date)
photograph of his/her body shape and weight of ______lbs. as of that date.
(insert weight)
Witnessed by:
Signature: ____________________________________
Print Name (first and last): ________________________
Address: _____________________________________
_____________________________________________
_____________________________________________
Contact Phone Number: _________________________
Please send this completed form via email to testimonials@yor.com or fax it to 949.681.6080.
2967 Michelson Drive, Suite G-338, Irvine, CA 92612 ♦ Phone: (949) 681-6088 ♦ Fax: (949) 681-6080 ♦ CustomerCare@Yor.com