Skip to main content

BETA PARTICIPANT VERIFICATION SUBMISSION

This field is hidden when viewing the form

Next Steps: Install the User Registration Add-On

This form requires the Gravity Forms User Registration Add-On. Important: Delete this tip before you publish the form.
Name(Required)
Email(Required)
Mailing Address (For jurisdictional/legal requirements)(Required)
MM slash DD slash YYYY
Photo of government-issued ID with all information on the ID fully legible. This image is required for identity verification, contractual validity, and age compliance, and will be stored securely in accordance with our data protection and record-keeping policies. Submission constitutes your confirmation that the ID is authentic, current, and belongs to you.
Max. file size: 512 MB.
Photo of government-issued ID with all information on the ID fully legible. This image is required for identity verification, contractual validity, and age compliance, and will be stored securely in accordance with our data protection and record-keeping policies. Submission constitutes your confirmation that the ID is authentic, current, and belongs to you.
Max. file size: 512 MB.
To proceed, please submit a verification photo commonly referred to as a “bunny ears” image. This photo must clearly display your face while you hold a valid, government-issued photo ID directly next to your face, with all information on the ID fully legible. This image is required for identity verification, contractual validity, and age compliance, and will be stored securely in accordance with our data protection and record-keeping policies. Submission constitutes your confirmation that the ID is authentic, current, and belongs to you.
Max. file size: 512 MB.
Legal Signature(Required)
This field is for validation purposes and should be left unchanged.