Create your story in 500 words or less. Complete the form below. Cut and paste your story into the large text box. If you would like to include a picture, you can email it to firstname.lastname@example.org
*Terms and Conditions I grant to the Heart Kids South Africa, its representatives and employees the permission to use the attached story, and/or associated photo in connection with the Share Your Story Campaign. I authorize Heart Kids South Africa, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Heart Kids South Africa may use such story and photographs of me or my responsible minor with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. By completing this form, you are also considered a Heart Kids South Africa partner and will be added to our partner database.