Liver Cancer Storyteller Interest Form |
Story Release and Consent Terms
By submitting this form, I agree to the following Story Release and Consent Terms:
I hereby grant permission for the Hepatitis B Foundation (HBF), Hep B United (HBU), and authorized partners to publish any content (stories, quotes, photos, videos, audio) that I submit through this form in HBF/HBU materials and media channels used for education, outreach, advocacy. This includes but is not limited to websites, social media, advertising, print and electronic newsletters, publications, posters, postcards, flyers, outreach/education/training materials, meeting or conference presentations, newspaper and magazine articles, radio, podcasts, and organizational reports.
I acknowledge and agree that the content I submit through this form may be edited (for example, to paraphrase, shorten, add clarification, or correct linguistic or grammatical errors), published, republished, distributed, and/or licensed by HBF now or at any time in the future for education, outreach, and advocacy.
I consent that my first or preferred name (unless otherwise requested by me), my age, the country where I live, and (if provided) the city and state/province where I live may be shared publicly along with any content that I submit through this form. I understand that my full name, email address, and phone number (if provided) will only be used for internal purposes at HBF and will not be shared publicly or with any other organizations without my permission.
I understand that submitting my story, personal information, and other materials through this form is completely voluntary. I release and hold harmless HBF, HBU, and authorized partners from any and all claims, demands, damages, losses, obligations, rights, and causes of action, whether known or unknown, relating in any way to this activity.
I confirm that I am 18 years of age or older.
I hereby grant permission for the Hepatitis B Foundation (HBF), Hep B United (HBU), and authorized partners to publish any content (stories, quotes, photos, videos, audio) that I submit through this form in HBF/HBU materials and media channels used for education, outreach, advocacy. This includes but is not limited to websites, social media, advertising, print and electronic newsletters, publications, posters, postcards, flyers, outreach/education/training materials, meeting or conference presentations, newspaper and magazine articles, radio, podcasts, and organizational reports.
I acknowledge and agree that the content I submit through this form may be edited (for example, to paraphrase, shorten, add clarification, or correct linguistic or grammatical errors), published, republished, distributed, and/or licensed by HBF now or at any time in the future for education, outreach, and advocacy.
I consent that my first or preferred name (unless otherwise requested by me), my age, the country where I live, and (if provided) the city and state/province where I live may be shared publicly along with any content that I submit through this form. I understand that my full name, email address, and phone number (if provided) will only be used for internal purposes at HBF and will not be shared publicly or with any other organizations without my permission.
I understand that submitting my story, personal information, and other materials through this form is completely voluntary. I release and hold harmless HBF, HBU, and authorized partners from any and all claims, demands, damages, losses, obligations, rights, and causes of action, whether known or unknown, relating in any way to this activity.
I confirm that I am 18 years of age or older.