Name *

First Name

Last Name

Phone *

(###)

###

####

Social Handle Platform *

Choose which platform we can find your social handle

TikTok

Instagram

Facebook

Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Can you drive to the shoot location? *

Near Philadelphia, PA, United States

Yes

No

Are you comfortable signing a release form? *

In order to post this video publicly, we may ask all participants to sign a release form.

Yes

No

Are you vaccinated? *

We will not be masking due to the scope of the work. Please answer honestly for everyone's safety.

Yes

No

Are you currently a member of the Mega Mango discord?

Yes

No

Would you like to receive future promotions from Mega Mango, such as upcoming events, merchandise drops, and new music? *

Yes, I would like to opt-in to future emails.