I, hereby consent to the use of my and/or my baby’s (babies’) story/photograph/video/audio recording submitted to Mothers’ Milk Bank of Tennessee for promotional or any other purpose whatsoever, and in whatever form. I understand that the Mission of the Mothers’ Milk Bank of Tennessee is to provide safe, pasteurized Donor Human Milk to High-Risk Infants in need when Mother’s own milk is not available and the Photographs/videos/audio recordings/ stories may be used to further that cause.

I release and relinquish to Mothers’ Milk Bank of Tennessee any and all rights I may have in and to the use of my story/photograph/video/audio recording.