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  • * If you are under the age of 18, your parent/guardian must fill this out with his/her info and then tell your story on your behalf.

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All photos and any other materials submitted to producer ("Materials") become the sole and exclusive property of producer and cannot be returned at any time. By submitting Materials, you agree producer may, but is not obligated to, use the Materials in connection with the show, in any way, in any medium, worldwide, in perpetuity. Further, you warrant all Materials are 100% original and do not violate the right of privacy or publicity of, or constitute a defamation against, any person or entity; that the Materials will not infringe upon or violate the copyright or common law rights or any other rights of any person or entity; that there are and will be no encumbrances, liens, conditions or restrictions whatsoever upon or affecting such Materials; and that you are at least 18 years of age and the person depicted in the Materials. You agree to indemnify producer and broadcaster for all damages and expenses (including reasonable attorney\'s fees) arising out of any breach or failure of the warranties made herein.

Contest ends on April 25, 2014 at 11:59 PM PST.