Consent for Birth Announcement Publication

If you are or were at any time a client of EdenWay Birth and you’d like your baby’s picture and birth stats included on our website on the “EdenWay Babies” page, please e-mail the following information to us with a picture:

Baby’s First and Middle Name:

Baby’s Birth Date:

Baby’s Weight and Length (if desired):

Your favorite memory of your baby’s birth (or if you’re up to it, an entire recount of your baby’s birth story):

When you e-mail this information, copy and paste the following paragraph into your e-mail, adding your name and the date in the appropriate places:

I, __________________________, understand that by submitting the following information for publication on www.EdenWayBirth.com, I consent to the publication of my baby’s picture, birth statistics, and/or birth story on the world wide web.  If at any point after (today’s date), I would like to withdraw my consent, I understand that I can do so by contacting EdenWay Birth via e-mail or in writing.  I further understand that removal of the information will be completed within one week of EdenWay’s receipt of the request, and that although the information will be removed, preventing further exposure, there is nothing EdenWay can do to prevent exposure that occurred during the time when my information was published.

Signed (electronically): Insert Your Name Here