VIDEO CONTEST ENTRY & CONSENT FORM
Questions to: Christina Mersereau cmersereau@homeofnewvision.org
Email address *
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City/State/Zip *
Your answer
Cell Phone Number
Your answer
Entry Date *
MM
/
DD
/
YYYY
Entry Title *
Your answer
How to Submit Your Entry
Upload your video to YouTube and share with cmersereau@homeofnewvision.org. Questions? Email me!
YouTube Address or URL *
Your answer
Electronic Signature (I certify that this is my own work and I own the rights to this work) *
Your answer
Consent & Release Agreement
Consent for Home of New Vision to use the work named above, which may include my name, image, likeness, and voice, in any medium and in any media outlet, throughout the year following the contest. This includes all social media platforms, email, internet, HNV video productions, any websites, or any other electronic or print media. Consent also provides that Home of New Vision is NOT liable or responsible for any repercussions, situations, or damages that may occur as a result of the publication of the work named above.
Electronic Signature (I have read and agree to the Consent and Release Agreement) *
Your answer
Contest Rules
1. Work must be original. You may not put your name on someone else's work.
2. Participants must be 14 years old and up, however kids may assist adults. You do not have to be in recovery to enter.
3. Videos should be 20 - 40 seconds long.
4. Work must not include any profanity or racist statements, images etc. Any work containing these will be disqualified.
5. Judges of the contest are ineligible.
6. One entry per person may be submitted. Multiple entries will be disqualified.
7. Two winners and two runners-up will be selected by a panel of 5 judges who are Home of New Vision staff.
8. The video creator and all persons depicted in the video must sign this release and consent form.
Electronic Signature (I have read and understand the contest rules) *
Your answer
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