Application | First Aid for Moms and Children Inc.

I give FAFMC permission to post myself and child(ren) on social media

I do not give FAFMC permission to post myself/child(ren) on social med

I give FAFMC permission to give photos of myself/child(ren) to donors

I do not give FAFMC permission to give photos of myself/child(ren)

I give FAFMC permission to use the first name of my child ONLY

I prefer FAFMC to use "Baby (first initial)" Example Baby S

The applicant is a minor. I am completing the application as her parent/guardian. I give FAFMC permission to serve my minor child and her infant.

APPLICATION FOR SERVICES