Identity Consent Form

Date(Required)

Name(s)(Required)

Address(Required)

Street Address

Phone

Email(Required)

I/We do hereby declare and warrant that I/we have the legal authority to, and do hereby, authorize and grant a non-exclusive license to Adoption Associates, Inc. and its affiliates for the use of photographs, video footage, original written material, etc., of ourselves and/or our child(ren) supplied by me/us for the purposes of marketing and promotion of adoption in any and all print, internet, video or other materials.

I agree (Adoptive Mother)

I agree (Adoptive Father)

Phone

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Identity Consent Form

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