Histio Awareness Photo Posters

If you are new to this group or haven’t had a poster size print of your histio warrior/survivor/angel made, the instructions for having one made is as follows:

*Please note we are unable to guarantee your histio heros photo will be held by someone in NYC. We have dozens of photos. The best was to ensure this is to join us.

Step 1

Purchase your poster through our secure check out to the right no later than JUNE 1, 2015.

Step 2

Please fill out the form below titled 'Histio Awareness Photo Submittal & Release Form' We will have 1 of those pictures made into a poster (the printer will pick best one to be enlarged). Please make sure the picture is only of your histio hero…no group shots.

If you would like to order more than 1 poster you MUST fill out this form for each poster after making your purchase.

Step 3

Pick up your poster! on Pier 84

Histiocytosis Awareness Poster

$25.00

Add to Cart

This is for 1 waterproof poster print on our new travel friendly size 15x18"

Please note* This product will not be directly mailed to you. Posters MUST be picked up at the NYC event.

Histio Awareness Photo Submittal & Release Form

* Indicates required field

Name *

First

Last

Email *

Please Verify *

I have PAID for my poster

Address *

Line 1

Line 2

City

State

Zip Code

Country

Photo Consent

Photo Consent for Self *

I AGREE

I, the above named person, hereby grant permission to Liam’s Lighthouse Foundation of Colorado Springs, Colorado, and its representatives, to use the following: photographs and/or digital images of me or my child, whose name is indicated on the signature line below in the upcoming Histio Awareness campaign arranged by Liam’s Lighthouse Foundation to be held in New York City at Rockefeller Center. I understand and agree that said picture might appear on national television, given the opportunity, or be used in printed or electronic publications, Web sites or other electronic communications. I further agree that only my child’s first name may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All prints and digital reproductions shall remain in the possession of Liam’s Lighthouse Foundation.

Consent for Child *

I AGREE Self application. Does not apply.

Child's Name *

First

Last

I, the above named person, parent or Official guardian of (child’s name) in box above (IF NOT FILLED IN THIS FORM WILL NEED TO BE RESUBMITTED),hereby grants permission to Liam’s Lighthouse Foundation of Colorado Springs ,Colorado, and its representatives, to take and use photographs and/or digital images of my child for use in news releases and/or educational materials as follows: printed publications or materials, electronic publications, or Web sites. I agree that my child’s first name may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All prints and digital reproductions shall remain in the possession of Liam’s Lighthouse Foundation.

Please Upload your images below

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Max file size: 20MB

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Max file size: 20MB

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Max file size: 20MB

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