The following is a Publicity Permission Release & Consent form. By Clicking on Agree, you will be taken to our guidelines where you will be prompted to submit your story. We thank you in advance for your time, your willingness to share your journey and your knowledge with other fathers.

Publicity Permission Release & Consent Form

I authorize the Postpartum Dads Project, its employees, agents, successors, assigns, subsidiaries and/or affiliates to use all information supplied by me in any or all of its publicity. Such shall include without limitation the use of any picture(s), photograph(s), life story and information.

This material may be used with or without using my name or by using my initials. The Postpartum Dads Project may use these materials in its entirety or in part. I understand that the publication or otherwise use of these materials is not subject to my inspection or approval. The materials may be used in various forms of media, including print, video, or audio.

I agree that I will not be compensated for the use of these materials. Any picture or photograph supplied to and/or taken by the Postpartum Dads Project shall be and remain the property of the Postpartum Dads Project.

I release, discharge, and agree to hold harmless the Postpartum Dads Project, its employees, legal representatives or assigns, and all persons acting under their authority from any liability that may occur from the publishing of this story, picture(s), photograph(s), or in its subsequent publishing or processing thereof. I also agree to hold harmless the Postpartum Dads Project. in the event that I submit materials such are not returned to me.

I state that if I have submitted any information that it is true and accurate. I also state that I have the authority to use and submit any materials and information given to the Postpartum Dads Project. I acknowledge that I am at least eighteen years of age. I understand that if I am less than eighteen years of age that my parent or guardian must authorize the release of this information. I also state that I have not given any person or entity the exclusive right to use my name, life story, picture or any other information.

By clicking this link I agree that I am above the age of 13 and hereby accept the above in its entirety.