Electronic consent form

Sickle Cell Disease Association Art Campaign
I, __, the parent or legal guardian of __ ("Participant”) do hereby agree to allow Participant to attend and participate in the Sickle Cell Disease Association Art Campaign (“Campaign”), and I consent to allow Terumo BCT, Inc. (“Terumo BCT”, including its affiliates, employees, successors and assigns) to use and publish Participant’s name (first name, last initial only) and original works of art in the Campaign, Campaign related activities, and for other legitimate marketing and promotional purposes. By signing this consent, participating in the Campaign, and submitting the original works of art, I hereby convey, transfer, and assign to Terumo BCT all copyrights, title, and interest in the works of art. I represent and warrant that I have the full right and authority to grant this consent on behalf of Participant. I waive all claims to compensation and any right to inspect or approve any works developed under this consent. I understand that my consent is perpetual, that I may not revoke it, and that it is binding on me, my heirs and assigns. By providing this consent, I waive any privacy rights and protections under all applicable law. 
Fields marked with * are required.
By signing below, I certify that I am 18 years of age or older and the legal parent or guardian of Participant. In addition, I certify that I have read, fully understand, and agree to the terms of this Consent, and I sign it voluntarily with the full knowledge of its significance.
If I am signing and submitting this Consent electronically, I acknowledge that my electronic signature shall have the same validity, force, and effect as if I affixed my signature by my own hand.
©2025 Terumo BCT, Inc. | All Rights Reserved | Privacy Policy | Terms and Conditions | TS-NONP-00444 | TerumoBCT.com