Gift of Parenthood, Inc. carefully and thoroughly reviews each application. We charge a nonrefundable application fee to cover the expense of this review. By nominating a family member or friend you are effectively covering their application fee. This fee is non-refundable. All information provided on this form is confidential and will not be disclosed outside of the selection committee and clinical advisors. However, by submitting your nomination, you grant Gift of Parenthood, Inc. an irrevocable, worldwide, royalty free, non-sublicensable license to reproduce or publish excerpts of your submission so long as all reproduced or published information is anonymized or does not reveal information that will personally identify you or others mentioned in your submission. If your submission contains personal information or photographs of other individuals, you attest that you have the permission of those individuals to disclose such information or photographs to us. You will indemnify us and hold us harmless against any claim by such individual related to your or our use of the individual’s name, image, likeness, or information disclosed in your application. You, the applicant, confirm and attest that all information you submit is true and correct to the best of your belief.