I authorize BrightFocus Foundation to use the materials identified below for purposes of sharing information. Materials about my event can be used by BrightFocus in its publications, presentations website, Facebook and other social media vehicles. These materials will help increase awareness of Alzheimer's, macular degeneration, and glaucoma.
* Indicates a required field
Contact Information: *
Choose a Program *
Share your Story or Caregiving Tips: *
Upload Photo/Image 1
(must be < 4 MB)
Upload Photo/Image 2
(must be < 4 MB)
Video Uploads
Please provide your YouTube link:
By checking the box below you are:
- Giving the BrightFocus Foundation permission to post the information on our website and use it in informational materials, and;
- Acknowledging that you have obtained signed consent forms from all individuals who participated in the photograph(s), audio recording(s), video(s), or written material(s).
After your information is reviewed for appropriate content, it will be promptly posted.
Please enter the text from the image below. *