Photo Submission

Parent/Caregiver name:*
Child/Children’s names:
One name per line
Photo(s)*
Drop files here or

Accepted file types: jpg, gif, png, jpeg, Max. file size: 2 MB, Max. files: 5.
I give permission for the use of images of myself and/or my children on the website of the Infant Mental Health Association of Aotearoa New Zealand (IMHAANZ).*
- Yes
I understand that our names will not be used in any material.*
- Yes
I understand that I may withdraw this consent at any time (by written notice).*
- Yes
I wish to place the following limitations on the consent form:
Expiry Date
MM slash DD slash YYYY
CAPTCHA