Welcome to our digital consent form.

Thank you for sharing your story, photos and/or videos with the ADNP Kids Research Foundation!
This is a DIGITAL CONSENT, please DO NOT complete this document if you do not agree to this digital consent form.
I hereby consent and agree that the ADNP Kids Research Foundation has the right to use photos/videos/recordings and/or stories/data (MEDIA) sent from me, of me or others in my MEDIA, and to use these for their respective websites, social media pages, informational publications, videos and promotional materials and my consent includes permission to edit for content and length.

I understand that names of individuals may be revealed therein or by descriptive text, third party tagging or commentary/comments made by others and cannot be controlled by the ADNP Kids Research Foundation.

If I submit MEDIA with any other person(s), including my own children, other adults and/or other children who are not mine, I acknowledge that it is my responsibility to get consent from all, including parents of any minors. I acknowledge that for my use of such photos and/or videos, I take full responsibility to acquire their consent and will disclose its use and release the ADNP Kids Research Foundation as noted in this digital document.

I do hereby release to the ADNP Kids Research Foundation all rights to exhibit this work publicly or privately, and I waive any rights, claims, or interests I may have to control the use of my photos and/or videos and agree that any uses described herein may be made without compensation or additional consideration of me.

Only MEDIA emailed to email addresses ending with @adnpfoundation.org will be used and included in this consent unless otherwise authorized by me in writing. I agree that any MEDIA to others representing ADNP Kids Research Foundation or any other similar organization are not included in this release.

By typing my name below, I represent that I have read and understand the foregoing statement.

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* 1. LEGAL FIRST ANDLAST NAME

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* 2. By selecting YES, I agree to this consent form.

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