Film Contest Release Form

I, the primary contact person submitting this video, affirm that the information contained in the submission is correct and I, the undersigned, voluntarily enter this agreement with Can't Beat Love Committee (Family Violence Prevention Services, Inc. and National Council of Jewish Women) and that solely students were involved in the production and editorial decision-making of the audio and visual elements, including editing and videography, with the understanding that the work will be disqualified if the judges deem the work not student produced either physically or editorially, and that my signature gives agreement to the use of the video and all materials submitted to this organization and may be used in any media worldwide deemed appropriate, related to this video contest and this organization, and signature to this form indicates that I agree that all judging results are final.

Primary Contact's Name *
Primary Contact's Name
Contestents under 18 *
Parent Phone *
Parent Phone

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All submissions and forms must be received by 4:00 p.m. on January 26, 2018.  For video upload instructions, click here.  Please be sure to check your email for submission confirmation.  Good luck!