Video Contest for High School Students 2022 Application Form

You will need one set of application forms for each video you want to submit. The video can be created by a single eligible student or a team of (up to six) eligible students.

The application form for one video will consist of

1. The cover form — listing the title of the video and the names and birthdates of everyone on the team (namely, those who will share dollars and/or glory of any prize awarded), and contact info (emails/phones) for at least two members of the team — and the names and birthdates of all “bit parts” and “featured extras” whose releases are attached
2. Individual release forms — each team member listed on the cover form must complete the interactive form, print and sign it, and scan it so it can be connected to the cover form.
   • If they are under 18, a parent must also sign agreement
3. Release forms for anyone acting a “bit part” or “featured extra”*

• • If they are under 18, a parent must also sign agreement for the video to be posted

All parts of the set of application forms for a single video must give the same title for the video and be sent in the same email requesting the Drop-Box link.

Before sending the application, please check that every team member’s form is completely filled in and all “bit parts” and “featured extras” have signed releases.

• A bit part has lines or a few scenes but is not a member of the “team” submitting the video
• A Featured extra has no lines but may have a name or receive good screen time, e.g., a waiter at the lead’s table who doesn’t speak.
• Emails and cell phones will be guarded by the selection committee and used only for our League members to reach out to students as needed.
  Cover Form for Voting Video Contest - Step 1 of 3

  Video Title *

  Full Name of Each Team Member

  1. Name:

  First

  Last

  Birth Date (M/D/Yr):

  Email:

  Cell Phone:

  2. Name:

  First

  Last

  Birth Date (M/D/Yr):

  Email:

  Cell Phone:

  3. Name:

  First

  Last

  Birth Date (M/D/Yr):

  Email:

  Cell Phone:

  4. Name:

  First

  Last

  Birth Date (M/D/Yr):

  Email:

  Cell Phone:

  5. Name:

  First

  Last

  Birth Date (M/D/Yr):

  Email:

  Cell Phone:

  6. Name:

  First

  Last

  Birth Date (M/D/Yr):

  Email:

  Cell Phone:

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

  1. Name:

  First

  Last

  Birth Date (M/D/Yr):

  2. Name:

  First

  Last

  Birth Date (M/D/Yr):

  3. Name:

  First

  Last

  Birth Date (M/D/Yr):

  4. Name:

  First

  Last

  Birth Date (M/D/Yr):

  5. Name:

  First

  Last

  Birth Date (M/D/Yr):

  6. Name:

  First

  Last

  Birth Date (M/D/Yr):

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  (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 Name (Printed):

  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

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  (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:

  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 Name (Printed):

  Date:

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