We are looking for students ages 6-10 to participate in a mock-class to film for a documentary raising awareness for an aggressive form of pediatric cancer.

Please complete this form to indicate willingness to participate for one hour, in your GRPL HAUS uniform on Sunday September 13th from 10am -11am.

Participants will be required to sign a release allowing their student to participate. You can see the contents of the release form below.

Indicate Interest Here

STATEMENT FROM THE FILMMAKER

In 2018 a six year old boy in Kentucky was diagnosed with a terminal form of brain cancer called DIPG. In the same moment of diagnosis his parents were told their son likely had 6 months to live. DIPF forms in the brain stem and is treatable but there is no cure, making it the most fatal form of pediatric cancer. In the following years David Jr lived every day to the fullest with the help of his family, the community of Louisville, and strangers across the country who heard his story and went out of their way to see him.

I had the honor of meeting his parents in 2022 and in 2023 I spent two days with them in Kentucky to capture their story and learn more about this disease- meeting his pediatrician, visiting his favorite spots around Louisville, and finally visiting him at his final resting place.

This form of cancer is not rare, not fair, and invisible until the late stages. Before the symptoms took effect, David Jr. was a very active kid- he spent a lot of time building Lego sets, painting, catching Pokemon, playing basketball, soccer, baseball, and of course practicing Jiu Jitsu. His Dad remarked that he would always come home after class trying new moves on Mom and pulling the mat out to try and make Dad tap out. His coaches would often mention that even if he was losing the fight or making mistakes he was always smiling and laughing and to me that says a lot about how much character he had even at 6 years old.

Part of my responsibility as a storyteller is to not only share the perspective of his parents and medical staff accurately, but to represent his own perspective in a way that is engaging and empathetic. The point of my collaboration with GRPL HAUS is to recreate the day that David Jr's symptoms first appeared- when he began to experience a headache during his Jiu Jitsu class which lead to an ER visit that changed his life forever.

In my time as a filmmaker I've worked with families in the context of commercials, documentaries, and nonprofits and throughout all of these interactions my priority is to keep the environment on set safe by communicating clearly, providing opportunities for breaks, and remaining open to questions every step of the way.
- Nate Cribari, Filmmaker

RELEASE LANGUAGE

Without expectation of compensation or other remuneration, now or in the future, I hereby give

my consent to the production Yuri Williams, Nathan Cribari, and Purpose Road Studio LLC as

well as their affiliates and agents, to use my image and likeness from me in its publications,

advertising, video platforms or other media platforms including but not limited to social media.

This consent includes (Initial where applicable):

______ (1) Permission to interview, film, photograph, record or otherwise make a video

reproduction of me and/or my voice.

______ (2) Permission to use quotes from the film, recordings, or reproductions of me and/or

my voice, in part or in whole, in print media, broadcast, audio platforms, video platforms and

social media.