2022 WaterWise High School Video Contest Release and Authorization Form (1 for each student participant)
All contest entrants must sign this release form attesting to the fact that they are the rightful owners of the submitted video. Each person appearing in the video or helping create the video must sign this release form even if she/he is not a high school student. A parent or guardian must sign this release form for any participant under the age of 18.
Student Participant's Name
*
First Name
Last Name
Student Email Address
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Title of Video
*
Date of Production
*
Name of High School
*
Certification
I certify that I am 18 years of age or older
I certify that I am the parent/guardian of the named participant who is under that age of 18
By signing below, I hereby assign all rights to the video and sound recordings of the video identified above. If need be, the rights for any necessary edits to be made for the video to be aired as a PSA. In addition, I hereby authorize the reproduction, copyright, exhibition, broadcast, and/or distribution of said video, or any other photography, videotape, footage, or likeness of the video without limitation. I, the participant, am the rightful owner of the video I submitted.
Submit
Should be Empty: