The following is for photos to be used by the Oklahoma Hemophilia Foundation.

Each adult must complete their own form.
A parent must complete the form for their child/children; you can write multiple names.
Thank you!

Name

First Name

Last Name

Children 18 and younger

Write the name(s) of the youth. Write NA if not applicable.

Email Address

Phone

(###)

###

####

Photo Release

I grant to the Oklahoma Hemophilia Foundation (OHF), its representatives and employees the right to take photographs of me and my property in connection with the above-identified subject. I authorize OHF, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that OHF may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. I have read and understand the above:

Message

The following is for photos to be used by the Oklahoma Hemophilia Foundation.

Each adult must complete their own form.

A parent must complete the form for their child/children; you can write multiple names.

Thank you!