HERSTORY Signup Form

In celebration of women working in cannabis 420MEDIA invites you to submit a short video/s about yourself that will start to stream on CANNECTED TV across ROKU, Apple TV, Android TV, Amazon Fire, IOS, and Google Play devices and online!
Please fill out and we will email a folder to upload videos to. Please follow the directions when uploading videos/s. For questions/concerns email

her-story@420media.agency

We will be in touch with you soon!

Please complete all information below:
PLEASE FILL OUT THE FORM, SIGN THE RELEASE FORM, AND UPLOAD PHOTO AND OUR COORDINATOR WILL EMAIL DIRECTIONS, A RELEASE FORM, AND FOLDER TO UPLOAD VIDEOS.
Name

First NameLast Name
E-mail
Personal or Company URL
Phone
Are you a cannabis/hemp/cbd/other

PatientPioneerWork in the spaceAll of the aboveOther
Tell us about yourself and experience in cannabis.
Why cannabis?
DIRECTIONS FOR UPLOADS (UP TO 3 VIDEOS)
- FILM HORIZONTALLY IN 1080
- NO BACKGROUND NOISE (A MICROPHONE IS SUGGESTED FOR BEST SOUND)
- NO EDITS
- NO TITLES
VIDEO 1:

My name is _____________________, I am a woman in cannabis.

VIDEO 2:

Share your story!

Upload a video up to 4 minutes (MAX) stating your

What brought you into cannabis?

Please DO NOT solicit or use this to advertise- it is to SHARE your story. Stating where you work or your company/brand is fine but no sales.

We have advertising options on the channel if that's of interest.

VIDEO 3:

What would you recommend to women entering the industry now?

All submissions are subject to approval and will be rejected if over 4 minutes. Please ask any questions prior to submission through email

her-story@420media.agency

WE CAN'T WAIT TO SHARE YOUR STORIES WITH THE WORLD!
Upload A Headshot or Photo Of Yourself

Cancelof

PERMISSION TO USE PHOTOGRAPHS AND VIDEOS THIS FORM ALLOWS US TO USE YOUR PHOTOGRAPHS/VIDEOS IN PROMOTIONAL MATERIALS FOR 420MEDIA AND CANNECTED TV PROJECTS. I, ____________________, HEREIN AUTHORIZE 420MEDIA AND CANNECTED TV TO USE, EDIT, COPY, EXHIBIT, DISTRIBUTE AND USE ANY VIDEO OR VIDEOS OF ME FOR ANY LAWFUL PURPOSE.THE AUTHORIZATION I PROVIDE HEREIN EXTENDS TO ALL LANGUAGES, FORMATS, AND MEDIA.I WAIVE MY RIGHT TO APPROVE AND/OR INSPECT A PRODUCT WHERE I APPEAR OR MY LIKENESS APPEARS.I HEREBY WAIVE ALL AND ANY RIGHTS TO ALL ROYALTIES OR ANY OTHER COMPENSATION IN ANY FORM WHEN IT COMES TO THE USE OF THE VIDEO OR VIDEOS INDICATED IN THIS FORM.I CONSENT THAT THE MATERIALS WILL BE THE SOLE PROPERTY OF 420MEDIA AND CANNECTED TV AND SHALL NOT BE RETURNED TO ME.I RELEASE 420MEDIA AND CANNECTED TV FROM ANY LIABILITY, PETITIONS, AND CAUSES OF ACTIONS CAUSED BY ME OR BY MY HEIRS, EXECUTIVES OR ANY OTHER PARTY AND WILL HOLD HIM/HER HARMLESS. I acknowledge the terms and conditions of this release form. 420MEDIA and CANNECTED TV properties reserve the right to reproduce these photographs/videos for commercial use.
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In celebration of women working in cannabis 420MEDIA invites you to submit a short video/s about yourself that will start to stream on CANNECTED TV across ROKU, Apple TV, Android TV, Amazon Fire, IOS, and Google Play devices and online! ​

PLEASE FILL OUT THE FORM, SIGN THE RELEASE FORM, AND UPLOAD PHOTO AND OUR COORDINATOR WILL EMAIL DIRECTIONS, A RELEASE FORM, AND FOLDER TO UPLOAD VIDEOS.

In celebration of women working in cannabis 420MEDIA invites you to submit a short video/s about yourself that will start to stream on CANNECTED TV across ROKU, Apple TV, Android TV, Amazon Fire, IOS, and Google Play devices and online!