* Email Address:
 * First Name
 * Last Name
* Address
 * City
 * Province
* Postal Code

 * Gender
female male		 *Age
*Phone Number
 Parents Email
  

If you are under 13 years of age, a parent or legal guardian must fill out the following information:

Yes, I, 's parent/legal guardian, approve of and agree to my child's participation in this Contest, and I understand that I may be contacted by the Sponsors at anytime at the email address or telephone number provided, to confirm such agreement.

Please send me information from Kernels regarding upcoming promotions and contests. (not available if you are under 13 years of age)
Please keep me informed of upcoming films and contests from Alliance Films.
(not available if you are under 13 years of age)
I have read and agree to the RULES AND REGULATIONS*