Don't Buy the Lie Contest Submission
Thank you for participating in the "Don't Buy the Lie" contest! Please take the time to fill out your information and submit your entry below! If you have any questions, contact Linh Vo at mvo@healthedcouncil.org. Check out past winners on our website: https://linktr.ee/hec_wellnessed
Your Name
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First Name
Last Name
Your Email
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example@example.com
Confirm Your Email
*
example@example.com
Your Phone Number
Birthdate
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-
Month
-
Day
Year
Date
School Name
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Grade Level
*
Parent/Guardian Name
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First Name
Last Name
Parent/Guardian Email
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example@example.com
Confirm Your Parent/Guardian Email
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example@example.com
Parent/Guardian Phone Number
*
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
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New Hampshire
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New York
North Carolina
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Ohio
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Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
This is our website below (https://linktr.ee/hec_wellnessed):
As part of the requirements, did you follow all directions under the DBTL Judging Criteria?
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Yes
No
As part of the requirements, did you attend a Zoom info session or have a guest speaker present in your classroom about the contest?
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No, I couldn't attend an info session but watched your DBTL videos on your website instead.
Yes, I attended one of the Zoom info sessions.
Yes, I had a guest speaker in my class.
Before participating in this contest, how aware were you of the risks associated with tobacco/marijuana use (scale of 1-5)
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1 = Not at all
1
2
3
4
5 = Very aware
5
1 is 1 = Not at all, 5 is 5 = Very aware
After watching our educational videos on our website (or attending an info session), I learned about the impact of Big Tobacco's lies and how they are affecting people's lives and the environment.
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1 = Not at all
1
2
3
4
5 = A lot
5
1 is 1 = Not at all, 5 is 5 = A lot
What were the some things you learned after creating your contest entry and participating in our "Don't Buy the Lie" contest?
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How did you hear about this contest?
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Instagram, Facebook, LinkedIn
Email
Flyer
Other
What topic does your creation include? (Select all that apply)
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Anti-tobaco
Anti-vaping
Anti-marijuana
What type of creation are you submitting?
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Dances, skits, or music (in video format)
Digital art
Handmade art (sketch, painting, mixed media, etc.)
Song lyrics, spoken word, or poetry (in written format)
Other
Did you work on this submission by yourself or with a group?
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By myself
With a group
I understand that it is optional to work on a submission with a group, but one person has to submit the project. If the submission wins, the prize money will only go to the person who submitted the project under their name. It is their responsibility to distribute the prize with the group.
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I understand
File Upload
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Browse Files
Drag and drop files here
Choose a file
If you're submitting a music video, can you please submit lyrics in a Word Doc as well.
Cancel
of
By participating in the Don't Buy the Lie contest, I consent to being photographed, filmed, and/ or recorded by the Health Education Council (HEC) and/ or approved third party vendors. I release HEC from any liability and understand the photo, video, or recording may be edited, published, and distributed externally for lawful purposes.
Yes
No
What are all of the names and initials of the person(s) shown in your video? (Name & Initials = John Doe, JD)
What are all of the names and initials of their parent/guardian(s)? (Name & Initials = John Doe, JD)
I hereby authorize Health Education Council, Kaiser Foundation, Kaiser Foundation Health Plan, Inc., The Permanente Medical Group, Inc., and any persons or entities acting at the request or discretion of Kaiser Permanente to display, distribute, reproduce, site, alter, and otherwise use the entry. I relinquish any and all ownership interest of or legal right related to the entry, and acknowledge that the entry is, after I submit it, the exclusive property of Health Education Council and Kaiser Permanente.
Youth Applicant's Signature
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Parent/Guardian's Signature
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Do you have any additional comments or concerns?
Submit
Submit
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