I agree that by submitting a creative arts piece to the  Capital Area Prescription Drug Misuse Prevention Art Competition and/or by appearing in such a video or art piece, I am voluntarily participating in educational efforts related to the contest.  

I certify that the works submitted are entirely my own works and have not been taken from another artist, website, media, or other resource. Plagiarism is not tolerated and will result in immediate removal of the art piece from this competition.  

I agree that my submission and/or appearance may be used in any efforts of Capital Area Prescription Drug Misuse Prevention. The Capital Area Public Health will have the right to reproduce, exhibit, perform, display, distribute and transmit the video or art piece (or authorize others to do so) in any manner and media (including online) worldwide.  

The Capital Area Public Health Network will be free to use my submission and/or my appearance in submitted material and in any derivative works.  

I consent to the publication of the transcript of material submitted and to the use of my name, likeness, voice, and/or biography to promote the efforts of The Capital Area Public Health Network, and I waive any rights of privacy and/or publicity that I might otherwise have with regard to the video/written piece, and any promotion or derivative work of the piece.

I understand that I will not be paid for my submission, appearance, or participation in the efforts of The Capital Area Public Health Network, or for the rights granted in this release.  

I CERTIFY THAT I HAVE READ THIS RELEASE BEFORE SIGNING IT AND THAT I FULLY UNDERSTAND ITS CONTENTS.

For Team Member/Actor/Actress appearing in the video/written/art medium who were/are under 18 years of age at the time of filming/writing, a parent or guardian must complete the following section.

I represent that I am the parent/guardian of the above named minor appearing in the student production/video or writing piece. I hereby consent to the foregoing on his/her behalf.