Christie Clinic Kids Submission Form

Christie Clinic Kids shares photos of the children we have had the privilege to care for. If you are a parent to child we’ve helped and you would like to share a photo with the community, please fill out the consent form below. Upload your Christie Clinic Kids’ photo and electronically sign to complete. The photo will be shared on the website and other media outlets.

Kid's Photo*
Only upload photos that you have full rights and permissions. Do not upload photographer’s proofs and/or photos with watermarks that you have not received rights to. You will be required to sign an online waiver as a guardian of your child to authorize Christie Clinic to use the photo in promotional materials.
Accepted file types: jpg, png, gif, jpeg, Max. file size: 128 MB.
Parent's Full Name*
Phone*
Email*
Kid's First Name*
Age
What is your favorite animal?
What do you want to be when you grow up?
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Post Title
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Parent Name (Hidden)
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Email (Hidden)
Phone
This field is for validation purposes and should be left unchanged.

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