Share your story about Kangaroo Care Day (May 15) Text/Photo/Logo/File/Video

Share your story about Kangaroo Care Day (May 15) Text/Photo/Logo/File/Video

Share your kangaroo care photos, videos, or files so we can share them on the website, social media, etc.
Upload Files (Photos or Videos)*

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Tell us your story about your experience with kangaroo care in first person, or how kangaroo care touched your life. If possible, relate it to the material(s) you are submitting. *

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While we may feature the files or text you submit without credit, please write the way to credit the photo/video/text if we use it on the website or social media. Who should we tag?
We respect everyone's privacy. Please note:
- By submitting a photo or video with adults, you certify that you have explicit permission from all of them to share it with us.
- The photos or files may be recent or old.
- There is no limit on the number of files, photos, or videos you submit.
- If there is a minor in any of the photos or files, the parent or legal guardian must have given you explicit consent to share the image or,
  Please share the link https://shorturl.at/akvC1 and request they fill out this form and submit the photo.
  Otherwise, blur or cover those who have not provided explicit consent to share or do not submit the photo or file.

I hereby authorize Kangaroo Care Day (May 15), and those acting with its authorization the irrevocable and unrestricted right and permission to copyright, use, and/or publish any text, photographic pictures, portraits, audio, or video of myself and/or my
minor child or children listed below, and our names and likenesses, for use in the Kangaroo Care Day (May 15)’s efforts, including but not restricted to print, online, and video-based educational, research, marketing, and other materials, as well as
other company or product publications and uses.

I hereby release and hold harmless Kangaroo Care Day (May 15) from any reasonable expectation of privacy or confidentiality for myself and the minor child and child listed below associated with the images specified above. Further, I attest I am the parent or legal guardian of the child or children listed below and have full authority to consent and authorize Nurtured by Design to use their likenesses, first name, and country of residence.

I further acknowledge that my/our participation is voluntary and that neither the minor child, the minor children, nor I will receive financial compensation of any type associated with the taking or publication of these photographs or participation in company materials or other Company publications. I acknowledge and agree that using or publishing said photos/videos confers no rights of opinion, ownership, or royalties whatsoever.

I hereby release Kangaroo Care Day (May 15), its contractors, its employees, and any third parties involved in creating or publishing Company materials from liability for any claims by me or any third party about my participation or the participation of the minor child(ren) listed below.

I hereby read the foregoing release, authorization, and agreement before affixing my signature below and warrant that I fully understand the contents thereof.

ACCEPTED AND AGREED by everyone in the photo/video plus the photo/videographer below.

Today's Date*

MonthDayYear
Date
Adult submitting this form*

First NameLast Name
E-mail address*
example@example.com
Phone number*

Area CodePhone Number
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
By signing you agree you own the rights of the media file submitted, and agree to the Consent and Release above. Signature*

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If there is a baby in the photo/video:
Parent, Legal Guardian Name (if different from above)

First NameLast Name
Parent or Legal Guardian email address
example@example.com
Parent or Legal Guardian Phone number

Area CodePhone Number
Name of Minor Child (1)

First NameLast Name
Date of Birth of Minor Child (1)

MonthDayYear
Date
Name of Minor Child (2)

First NameLast Name
Date of Birth of Minor Child (2)

MonthDayYear
Date
Name of Minor Child (3)

First NameLast Name
Date of Birth of Minor Child (3)

MonthDayYear
Date
By signing you confirm you are the parent or legal guardian of the minor(s) and agree to the Consent and Release above. Parent or Legal Guardian Signature:*

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Photographer/Videographer
Photographer/Videographer Name

First NameLast Name
Photographer/Videographer email address
example@example.com
By signing you agree to the Consent and Release above. Photographer/Videographer Signature*

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