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Share an Inspiring Story of a Pediatric Cancer Patient

This nonprofit organization is aimed toward raising awareness at pediatric cancer and helping those children put a smile back on their faces. If you know of a friend or a family member suffering from pediatric cancer we would love to help. Please upload a short video of the child via, YouTube, DropBox or Google Drive. In the video, please include the type of cancer the child is suffering from along with their story, and one thing that simply puts a smile on their face. Please make this more of a home video and not an interview. For example, a home video of the child’s day to day. However, you may include a short interview at the beginning or end of yourself explaining the current situation or of the child. Once a video is chosen we will be in contact for the beginning stages of sponsorship. This will include a short video of the child posted to our Stories tab for donors to contribute to. After a 3 month period we will collect and present all donations to that child. This interaction will be video graphed by a videographer and uploaded back to the site for all donors to view on the smiles tab. Also please provide your name, number, address and the link to the video in the comments section. Thank you.

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Story Submit Form

Video Release Form

Conditions

I hereby grant the Smiles Are Forever, its directors, officers, employees, agents, and designers (collectively “Smiles Are Forever”) non-revocable permission to capture my image and likeness in videotapes, motion pictures, recordings, or any other media (collectively “Images”). I acknowledge that Smiles Are Forever will own such Images and further grant the Smiles Are Forever permission to copyright, display, publish, distribute, use, modify, print and reprint such Images in any manner whatsoever related to Smiles Are Forever business, including without limitation, publications, advertisements, brochures, web site images, or other electronic displays and transmissions thereof. I further waive any right to inspect or approve the use of the Image by the Smiles Are Forever prior to its use. I forever release and hold the, Smiles Are Forever, harmless from any and all liability arising out of the use of the Images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the Images, including without limitation, claims for invasion of privacy rights or publicity.

I hereby warrant that I am eighteen (18) years old or more and competent to contract in my own name or, if I am less than eighteen years old, that my parent or guardian has signed this release form below. This release is binding on me and my heirs, assignees and personal representatives.