#girlinthewhitehouse™ Participant Registration Form
- a social media campaign of the Girls in Politics Initiative™ -
The #girlinthewhitehouse™ campaign asks girls to finish the statement “If I were President of the United States
of America, I would _____________________________. Through the #girlinthewhitehouse™ we set out to
achieve the following goals:
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Give 2,016,000 girls a platform to share their ideas in the 2016 election.
Prompt girls to think about the issues that impact their lives and communities.
Demonstrate for girls how they can change their world through advocacy and political leadership.
Prove that girls have a vital role to play in politics as leaders and that girls do contribute substantive
ideas for solving the nation’s biggest problems.
5. Noting that the United States is long overdue for a woman President the #girlinthewhitehouse™
campaign will further normalize the idea of a woman in the White House.
6. Amass a collection of 2,016,000 videos from girls by the 2016 election – Tuesday, November 8, 2016
Participation Guidelines:
1. Print and complete the Photo & Video Release form
2. In natural light, preferably during the day girls have parents record them holding their
#girlsinthewhitehouse and reading the script.
Note: Participants please limit your script to one or two issues that you would address as President.
Script:
My name is ____________________________ and if I were President of the United States, I
would ____________________________________________.
3. Email the video and photo/video release form to girlinthewhitehouse@girlsinpolitics.org and give the full
name and age. Only the participant’s first name will be displayed in the caption that will be added to the
video.
Photograph & Video Release Form
I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video tape
without payment or any other consideration. I understand that her image may be edited, copied, exhibited, published
or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I
waive any right to royalties or other compensation arising or related to the use of her image or recording. I also
understand that this material may be used in diverse educational and social media settings within an unrestricted
geographic area.
Photographic, audio or video recordings may be used for the following purposes:
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#girlinthewhitehouse™ social media campaign
conference presentations
educational presentations or courses
informational presentations and educational videos
on-line educational courses
By signing this release I understand this permission signifies that photographic or video recordings of me may be
electronically displayed via the Internet or in the public educational setting. I will be consulted about the use of the
photographs or video recording for any purpose other than those listed above. There is no time limit on the validity of
this release nor is there any geographic limitation on where these materials may be distributed. This release applies to
photographic, audio or video recordings collected as part of the #girlinthewhitehouse™ social media campaign only.
By signing this form I acknowledge that I have completely read and fully understand the above release and agree to be
bound thereby. I hereby release any and all claims against any person or organization utilizing this material for
educational purposes.
Full Name___________________________________________________
Street Address/P.O. Box________________________________________
City ________________________________________________________
Prov/Postal Code/Zip Code _____________________________________
Phone ___________________ Email Address____________________________________________
Signature______________________________________
Date____________________________
If this release is obtained from a presenter under the age of 19, then the signature of that participant’s parent or legal
guardian is also required.
Parent Full Name: __________________________________________________________________
Parent’s Signature__________________________________ Date____________________________