How Have our Films Impacted You?

If one of our films impacted you in any way, we would love to hear your story.

FOR ALL AGES, please include your NAME and EMAIL ADDRESS below to complete the form.

Name(Required)

First Last

Email(Required)

Your Story(Required)

Thank you for sharing your story with us.

In order to make sure we are all on the same page, we want to make sure we have your permission to share your story and that we understand the level of anonymity you desire.

By completing and submitting this form, you agree to the following:

1. You grant us permission to publicly share, publish, reproduce, edit, adapt, and display the story you have given us, whether over Instagram direct message, email, or any other form of communication (“Your Story”). You agree that the permission you are granting to us is permanent and cannot be revoked. You agree that we can use Your Story in any format or medium for purposes of including in the Awareness Campaign, and that we do not owe any financial compensation to you for doing so.

2. You agree that you are freely and voluntarily granting us the permission described in #1, above.

3. You promise that your story as you have provided it to us is true and correct according to your honest recollection of events. You promise that you are not using someone else’s story.

4. You understand that we will exclusively own all materials used in the Awareness Campaign, even those materials that incorporate Your Story. To be clear, we do not own Your Story—we simply own the Awareness Campaign materials that incorporate Your Story.

5. You promise that you are at least eighteen years of age.

Please choose one of the following options regarding the level of anonymity you desire in us sharing your story.

Completely anonymous (we will use a pseudonym)

First name only

Full name

OR, if under 18:

Phone

This field is for validation purposes and should be left unchanged.