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DO NOT ATTEMPT OR SUBMIT VIDEOS OF DANGEROUS OR ILLEGAL BEHAVIOR. THESE VIDEOS WILL BE REJECTED AND UNPAID.

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First name *

Last name *

Email *

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Age group *

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Telephone *

Mailing address *

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This is a legal document.

Thank you for submitting your video to VAD – you're almost there!

To get your video fully ready to air on TV and eligible to receive $500, please answer just a few questions about your video by clicking the button below.

Are you the owner of the video that you have submitted?
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Please provide the name of your parent or legal guardian. *

Please provide the email address for your parent or legal guardian. *

Please provide the owner's name.

Please provide the owner's email address.

Is this person (the owner) that you’ve provided over 18 years old?
Yes No

If you have it, please provide the name of the Parent (or Legal Guardian) of the Owner

Please provide the email address for the Parent (Legal Guardian) of the Owner

Did you shoot the video?
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Who did shoot the video – what’s his/her name?

Please provide the shooter’s email

Is this shooter that you’ve provided over 18 years old?
Yes No

If you have it, please provide the name of the Parent (or Legal Guardian) of the shooter

Please provide the email address for the Parent (Legal Guardian) of the shooter

To the best of your knowledge, please select how many people are seen in the video?

Please provide as many names, brief descriptions of people seen and/or heard in the video, and their respective email addresses by filling in the fields below. If you do not know, simply skip this step by clicking NEXT below.

Have you submitted this clip anywhere else?
No Yes

Please list the other TV shows, websites, or any other media outlets where the video has been given and/or shown

Are the events in the video real (not staged)?
Yes No

Please describe the circumstances surrounding the events in the video

That's it! Please click "Submit" to send your information to VAD.

Error during upload. Please try again. You haven't selected a video file to upload! Please complete step 1. Thank you! Your information will be sent to AFV as soon as the video file finishes uploading. It looks like the file you selected is not a video file. Please try again. Choose File english