ASH1L WARRIOR STORY

ASH1L WARRIOR STORY

Share your ASH1L Warrior story
Story Author Details *

First Name Last Name
Email *
example@example.com
Your relationship with ASH1L Warrior *

Self Biological Parent Guardian Patient Advocate Caregiver Medical Advisor Other
ASH1L Warrior Name *

First Name Last Name
ASH1L Warrior Date of Birth *

Month Day Year
Date
Country *
Write your story here *
If you have submitted the story or would like to submit it through email, then kindly type in N/A in the area provided. The email address to email your story is info@care4ash1l.com
Please upload any photos and videos you like to share *

Cancel of
Do you give Care4ASH1L the permission to publish your story, photos and videos on social media - Facebook, Twitter, LinkedIn, Instagram, Care4ASH1L website and other awareness as well as fundraising campaigns? *

Yes No
Permission to publish - By selecting "YES" you are agreeing to the terms and conditions to submit your story, photo(s) and video(s). By clicking "YES", you grant Care4ASH1L permission to use your story, photo(s), video(s), name, age, gender and country on our website, and as part of our ongoing programs to increase rare disease awareness. By selecting "YES", you hereby grant permission to Care4ASH1L and its agents or employees to use your ASH1L Warrior’s story, photo(s) and/or video(s) for publication in brochures, newsletters, display boards, social media accounts, and websites without notifying you. You acknowledge that Care4ASH1L may choose not to use the story, photo(s), video(s) at this time, but may do so at its own discretion at a later date. You agree that Care4ASH1L reserves the right to discontinue use of photos without notice. By clicking "YES", you agree that you have read this release and the FAQs below before submitting and that you fully understand the contents, meaning, and impact of this release. *

Yes
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