Share Your Story

This consent form is required for any photos that have been attached.
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I hereby give my permission to the Cerebral Palsy Research Foundation of Kansas, Inc. to use my name, testimonial, photograph, and/or video image in any official CPRF publication, on the CPRF website, CPRF social media, and/or CPRF marketing material.

I understand that this consent may be revoked by me at any time for further use of my information and image (photo and/or video) from the date of notification to the CPRF Public Relations office and forward. Revocation will not be retroactive.