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Submit Champion
To contribute a story, please complete the following form. All stories will be reviewed prior to posting to ensure content is consistent with our editorial guidelines. Diabetes Champion stories will be posted as quickly as possible. Thank you for sharing your story and participating in World Diabetes Day Canada!
1
About you
2
Your Champion
3
Photo
4
Disclaimer
Tell us about yourself
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Email
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Who are you nominating
Name
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First
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Province
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Story
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Tell us your story
Select media (Photo, Link) to upload
Photo
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Link
Submit an audio or video link
I/We hereby consent and agree that the Canadian Diabetes Association and Juvenile Diabetes Research Foundation, its successors, administrators or assigns (hereinafter referred to as “CDA” and “JDRF”) have the right to publish my/our story, comments and/or photograph (collectively the “Material”) for use in joint CDA and JDRF World Diabetes Day (hereinafter referred to as “WDD”) campaigns, promotions, advertisements and in any other way that furthers CDA and JDRF’s WDD objectives. I/We understand that the Material may be published in any and every form of media in both domestic and foreign markets and may be included in whole or in part, in colour or in black and white.I/We hereby release and discharge CDA and JDRF and all persons acting under CDA and JDRF’s permission or authority or those for whom CDA and JDRF is acting from and against any liability resulting from the foregoing use of the Material or from any distortion, blurring, alteration, and/or use in composite form, whether the same is intentional or otherwise, that may occur in the taking of, processing, reproduction, or presentation of the Material.I/We hereby waive my/our right to inspect and/or approve the finished story, comments and/or photograph, film or video in whatever media the Material may be used or the eventual use to which the Material may be applied.As part of the release, I/we hereby assign to CDA and JDRF any copyright that I/we may have in the Material, and also specifically waive any moral rights that I may have with respect to the Material.I/We have read the foregoing release and warrant that I/we fully understand the contents thereof.It is understood that my/our identity may be used by CDA and JDRF when publishing/releasing WDD information as noted in this document.
Agreement
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I have read the agreement and agree to its terms and conditions
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