Forms for Review

(Each member of the team must fill out their own release form, and the single application must include all releases in one package to receive the link for submitting the video)

Video Title *

Others on This Team

Your Name: *

First

Last

Your Birth Date (M/D/Yr): *

Your Email: *

Your Phone #: *

Your High School (name):

Your expected graduation date (Year):

I agree that whether or not my/our entry is selected for a prize or honored as a finalist

• It cannot be represented as a League video or as an entry in a League contest without advance written permission from our League
• Should contestant(s) want to submit it in applications or as part of portfolios of their work, permission will not be withheld unreasonably

I agree that If my/our entry is selected for a prize or honored as a finalist

• I will seriously consider making any requested revisions to the submitted video.
• the League may, at its discretion, add opening and/or closing credits, which may include the League logo, contest description, contestant name(s) and roles — the League agrees to consult with my team about our preferences on these, if any
• To grant the LWV an on-going permanent license to post it on LWV-controlled platforms, including LWV-controlled social media — and the LWV may describe it as “prize-winning,” “honored,” “selected by the League,” etc. — and may identify the creator/team members by name, high school, and/or the prize won.

Your Signature: *

Date:

Contestants under age 18 as of the date of this submission will need a parent/guardian to sign their agreement to above contest stipulations: *

I agree that my child’s video submission may be submitted under the terms defined above

Parent/Guardian Signature: *

Date:

Parent/Guardian Signature: *

Date:

If the video includes actors (with or without speaking parts) beyond the contestants, a signed release (with parent’s signature for those under age 18), must accompany the submission for each such person.

Name *

First

Last

Email *

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Rules of Entry

1. To participate, complete an entry form with your name, address, and phone number, and submit it online.

2. The contest will be conducted March 17th through April 28th, 2017. Deadline for entries is April 28th, 2017. Grand prize drawing will be held on Wednesday, April 28th at the Convention Center.

3. You must be 21 years of age or older to win. No purchase necessary. One qualifier per household. You need not be present to win. Void where prohibited.

4. Approximate value of the prize is $1000.

Agreement *

I agree to the Rules of Entry.

(Each such actor in the video must fill out their own release form, have it signed by a parent/guardian as appropriate, and have it included in the single Application)

Video Title *

Others on This Team

Your Name: *

First

Last

Your Birth Date (M/D/Yr): *

Your Email: *

Your Phone #: *

Your High School (name):

Your expected graduation date (Year):

I agree that If the above named video is

• Selected for a prize or honored as a finalist, to grant the LWV an on-going permanent license to post it on LWV-controlled platforms, including LWV-controlled social media — and the LWV may describe it as “prize-winning,” “honored,” “selected by the League,” etc.
• Not selected for a prize or honored as a finalist, that I may not represent it as a League video or as an entry in a League contest without advance written permission from our League

Your Signature: *

Date:

If you are under age 18 as of the date of this submission, you need a parent/guardian to sign their agreement to above release. *

I agree that the video submission that includes video/audio of my child may be submitted under the terms defined above, granting the League of Women Voters of Port Washington-Manhasset an on-going permanent license to post it on LWV-controlled platforms, including LWV-controlled social media.

Parent/Guardian Signature: *

Date:

Parent/Guardian Signature: *

Date:

Full Name of Each Team Member

Names and Birthdates of anyone (not named above) in “bit parts” or “featured extras”

Full Name of Each Team Member

Names and Birthdates of anyone (not named above) in “bit parts” or “featured extras”

GDPR