Register - Genius Tag

First name^*

Last name^*

Email address^*

Phone Number^*

Password^*

Confirm password^*

Verification Code Sent by Text Message^*

Affiliate type^*

Ambassador

I am an individual who wants to promote the product.

Partner

I represent an organization that wants to promote the product.

Affiliate Contact Email^*

Affiliate Contact Phone Number^*

Mailing Address

Address Line 1^*

Address Line 2 (optional)

City^*

State^*

Postal Code^*

Social Media Profiles^*

Platform^*

URL/Handle^*

I agree to the following terms and conditions^*

I grant permission to GeniusTag and Ad Pros International LLC, to use my creatives (static/video) for public use online, including but not limited to; social media posts, online ads, emails, newsletters, websites, etc.

I hereby waive any right to inspect or approve the finished and published media that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the creatives.

I acknowledge I am 18 years of age or older and I am competent to contract in my own name.