Tell Us Your Story - Video Submission

Stop Colon Cancer Now encourages you to share your story through written or video testimonials. Let your experience help the thousands of patients, survivors, caregivers and loved ones affected by colon cancer across the world.

First Name: *

Last Name:

City: *

State: *

Age: *

Email: *

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Disclaimer: *

I understand that the information, video content and/or textual content I have voluntarily provided to the Stop Colon Cancer Now website (the “Content”) is not protected health information and that it may be reproduced in part or in its entirety by Stop Colon Cancer Now and its sponsors for marketing purposes on this website, YouTube or other mediums. By uploading, transmitting or posting any Content to the Stop Colon Cancer Now website, I grant to Stop Colon Cancer Now a perpetual, non-exclusive, worldwide, royalty-free license to use, copy, print, display, reproduce, publish, modify and distribute the Content in whole or in part. I agree that any and all Content I submit will not contain material that violates any right, including without limitation, the copyright, of a third party. I understand that I am solely responsible for the Content and the consequences of posting or publishing such Content. Stop Colon Cancer Now acknowledges that all ownership rights in the Content are retained by me. I agree that only my first name, city and state will display next to my testimonial, and that the rest of my information will remain private. I attest that I am over 13 years of age.

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Tell Us Your Story - Video Submission

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