Share Your Smile

Submit a Photograph

Guidelines:

  • Your photo must clearly show teeth and/or orthodontic appliances on teeth
  • The orthodontist who completed the work MUST be a member of the CAO
  • Tell us what makes you smile – for example “Getting A+ on my assignment” or “My favourite team getting a hat trick”
  • The CAO reserves the right to decline to post a submitted selfie and quotation for any reason

All fields marked with an asterisk (*) are required.

 

First Name *
Last Name *
Orthodontist *



Email *
Address *
Province *
City *
Postal Code *
Image *
(.gif, .jpg, .jpeg, .png)
Date of Birth *
What makes me smile *

AUTHORIZATION FOR USE OF PERSONAL INFORMATION, IMAGE AND QUOTE Canadian Association of Orthodontists “Show Off Your Selfie Smile”

In connection with my inclusion in the Canadian Association of Orthodontists’ (CAO) “Show Off Your Selfie Smile” section of http://yoursmileourspecialty.ca/, I give my permission to the CAO and its associates to use my image and likeness (“selfie”) and personal information, including but not limited to: my first name and last initial, my orthodontist’s name, the city and province in which the orthodontist practices, and my quote that explains what makes me smile, for any lawful purpose the CAO deems appropriate, including but not limited to advertising to the general public (including via social media, internet or other electronic publications), illustration, and publication to the public at large for educational and/or marketing purposes.

I understand that CAO will make reasonable efforts to safeguard information about my health, but also understand that my inclusion in “Show Off Your Selfie Smile” requires the disclosure of some of my personal information, including my first name and last initial, my orthodontist’s name, the city and province in which the orthodontist practices and my quote to explain what makes me smile.

I give permission to the CAO to use my first name and last initial and my image and quote in support of “Show Off Your Selfie Smile” on all CAO online assets, some of which are public domain sites (i.e., Facebook), as well as the CAO’s newsletters for its members, including, but not limited to, The CAO Bulletin.

I also understand that, given the nature of online and internet media, the CAO cannot guarantee my complete privacy or prevent use of my submission by unauthorized third parties. I will not hold the CAO liable for use of this submission or any part of it by unauthorized third parties.

I hereby relinquish any and all rights to my image obtained by any photographic or digital means that have been submitted to the CAO. I understand that I am entitled to no consideration, remuneration or payment for the use of my mage, name or quote in any advertising, promotional or educational materials by the CAO.

I understand any image or likeness of my submission may be altered prior to use if deemed appropriate by the CAO. I understand and agree that I have no right to be consulted about or approve of any such alterations before my image is used.

I understand that the CAO is under no obligation to use my submission and that it reserves the right, in its absolute discretion and for any reason whatsoever, to decide not to do so. I agree that the CAO incurs no liability in the event it does not use my submission. I understand that the CAO will make its best efforts to ensure unused submissions are destroyed or securely deleted, but that no liability accrues to the CAO in the event my unused submission is illegally retrieved and/or used by unauthorized third parties.

I also understand that my submission must be reviewed prior to upload and, if chosen, a reasonable amount of time may elapse before the submission is uploaded to http://yoursmileourspecialty.ca/

 


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