Local Spit Tobacco User Video Interviews

We've limited the schedule time to 3 days: Feb 15-17th.  Please pick a time that works best for you.  We'll reach out to confirm the time works for our schedule and yours.

Select your appointment time below.

Below is a required permission statement... Basically, by signing, you're giving us permission to edit the videos we shoot of you and share them online.  We promise, we're not going to make you look bad.

I hereby grant to the Youth Advocacy Partnership and others working for it or on its behalf, and their respective licensees, successors, and assigns (collectively, "Client"), the unlimited right and permission to use, distribute, publish, exhibit, digitize, broadcast, display, reproduce my name, picture, likeness, voice and biographical information, or any material based thereon or derived therefrom, or to refrain form so doing, in any manner or media whatsoever (whether now known or hereafter devised) anywhere in the world for the purposes of advertising or trade in promoting and publicizing Client and its products and services.I shall have no right of approval, no claim to compensation, and no claim (including, without limitation, claims should be based upon invasion of privacy, defamation, or right of publicity) arising out of any use, alteration, blurring, distortion, faulty reproduction, illusionary effect or use in any composite form of my name, picture, likeness, voice and biographical information. I have the full right and authority to grant the rights granted hereunder and I agree that this Consent and Release does not in any way conflict with any existing commitment on my part. I have not heretofore authorized (which authority is still in effect), not will I authorize or permit the use of my name, picture, likeness, voice and biographical information in connection with the advertising or promotion of any product or service competitive to or incapable with those of Client. By signing below, I give my consent.