ASTS Photo Release Form


I hereby authorize American Society of Transplant Surgeons (ASTS) to use my photos, name, and/or other information for use on all ASTS sponsored social media sites and website.  
By checking this box:

If minor children are included in the photographs I have provided, I have the right to authorize ASTS to use these photos.  Both parents/guardians are required to provide their signature authorizing ASTS to post this photo.   

If this does not apply to you, you can skip this section and submit the form. 

Please include the street address, city, state, and zip code below
Parent/Guardian (1) by checking this box:
Please include the street address, city, state, and zip code below
Parent/Guardian (2) by checking this box: