interested in BEING MEDIA at Kushstock?

Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I hereby verify that I am over the age of 21+ & have a Valid Photo ID. *

Yes

Birth Date *

MM

DD

YYYY

Have you attended the Kushstock Festival before? *

Yes

No

I understand and agree that the Kushstock Festival, the Adelanto Stadium, and any of their affiliates are not responsible for any injury or property damage arising out of KUSHSTOCK Activities, even if caused by their ordinary negligence or otherwise. I understand that participation in the KUSHSTOCK Activities involves certain risks, including, but not limited to, serious injury and death. I am voluntarily participating in the KUSHSTOCK Activities with knowledge of the danger involved and I agree to accept all risks of participation.

Yes