Publicity Consent Form
I have authority to give consent for me and my family below (if applicable). In giving consent I understand that information and images of my family members and I listed below may be used for various media and promotional purposes for Fertility New Zealand. I also understand that information and promotional images and material may be used without limitation for Fertility New Zealand marketing materials, newsletter, social media, website and various other mediums and first namesonly may be used. I understand that there will be no payment made for the use of this information and images. I will contact Fertility New Zealand if I have any questions.
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Email *
Contact Name *
We will send you a few copies of the Dandelion. What is your address: *
Contact Number *
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