ENERGY VIDEO CHALLENGE Main Form

ENERGY VIDEO CHALLENGE

Presented by Phenom Entertainment Group ("PEG") in Partnership with Coda and Collectiv
MAIN CONTEST SUBMISSION FORM
Thank you for participating in the ENERGY Video Challenge. All entries are subject to the Official Contest Rules. Incomplete, fraudulent, duplicate, manipulated, or unverifiable submissions may be disqualified.
PARTICIPANT INFORMATION
Full Legal Name

First NameLast NameSuffix
Email

Confirmation Emailexample@example.com
Mobile Phone Number

Country CodeArea CodePhone Number
Date of Birth

MonthDayYear
Date
Country
State/Province
City
CODA VERIFICATION
Have you signed up for a Coda account?
IF YES:
Coda Email Address Used for Signup
example@example.com
Approximate Date of Coda Signup

MonthDayYear
Date
IF NO:

Please be sure to complete the Alternate Method of Entry (“AMOE”) form.
SOCIAL MEDIA INFORMATION
TikTok Username
Instagram Username
YouTube Username
Facebook Username
Platform Used for Contest Entry
VIDEO SUBMISSION INFORMATION
Direct Link to Contest Video
Date Video Was Uploaded

MonthDayYear
Date
Video Title or Caption Used
Required Hashtags Used
Confirm your video length is between forty-five (45) and sixty (60) seconds
PARTICIPANT CERTIFICATIONS
Participant is at least eighteen (18) years of age
Participant has read and agrees to comply with the Official Contest Rules
Participant understands that this is a skill-based promotional contest and that winner selection is not random
Participant confirms that the submitted video is original and created by participant
Participant owns or has obtained all necessary rights, permissions, licenses, approvals, and consents related to the submitted content
Participant has obtained permission from all identifiable individuals appearing in the submitted content
Participant understands that fake engagement, bots, AI impersonation, deepfakes, manipulated engagement, spam activity, or fraudulent participation may result in disqualification
Participant understands that PEG reserves the right to verify eligibility, identity, ownership of content, and compliance with contest rules
Participant understands that submitted content may be used for promotional, advertising, marketing, editorial, and commercial purposes by PEG, Coda, participating artists, sponsors, affiliates, and promotional partners
Participant understands that submission of this form does not guarantee finalist or winner selection
ELECTRONIC SIGNATURE
Participant Signature
Printed Name
Date

MonthDayYear
Date
IMPORTANT NOTICE

Incomplete, false, misleading, fraudulent, duplicate, manipulated, or unverifiable submissions may be disqualified.

PEG reserves the right to request additional information, identity verification, proof of ownership, or supporting documentation at any time.

Submission of this form constitutes acceptance of the Official Contest Rules and all decisions made by PEG, which shall be final and binding in all matters related to the contest.
Verification
Should be Empty:

ENERGY VIDEO CHALLENGE

PARTICIPANT INFORMATION

CODA VERIFICATION

SOCIAL MEDIA INFORMATION

VIDEO SUBMISSION INFORMATION

PARTICIPANT CERTIFICATIONS

ELECTRONIC SIGNATURE