October 4, 2017

 

Please let this letter serve as authorization to use your family’s photographs and bio information on the Christianson Syndrome Association Website, Christianson Syndrome Europe Website and any other official CS affiliates or documents.  By signing this form you authorize the above organizations to place your families (including your minor children) photographs and bio information on the organizations websites  www.csa-cares.org, www.cs-europe.org or their newsletters or publications.

CHRISTIANSON
SYNDROME ASSOCIATION

15201 Mason Road Sye100 #173   Cypress, TX
77433, USA


www.csa-cares.org

 

Deborah Nash

President

Christianson Syndrome Association

CHRISTIANSON
SYNDROME EUROPE

Van Sybergstraat 2, 7631 JE, Ootmarsum, The
Netherlands

 

www.cs-europe.org

 

Monique Snijder

President

Christianson Syndrome Europe

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Consent Form

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IDODO NOT consent to and authorize the use and reproduction by Christianson Syndrome Association & Christianson Syndrome Europe of any and all photographs and any other audio/visual materials taken of me, my family (including minor children) for promotional material, educational activities, exhibitions or for any other use for the benefit of the association.

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