Video Contest Entry Form
Videographer Profile and Release
CONTACT INFO (please indicate preferable means of contact)
Phone number ________________________________________
Video Title ___________________________________________________________________________
Please do not submit audio with music that is not original or open source unless you have received a transferable license to use it.
RELEASE: I understand that by submitting my video I grant the Farmington Land Trust, Inc the use of all or part of my (my child’s) work product for promotion of the Farmington Land Trust and its properties.
Signature of videographer (and if under eighteen, a parent or legal guardian)
Farmington Land Trust, Inc., The Canal House, 128 Garden Street, Farmington, CT 06032
Phone: (860) 674-8545, E-mail: email@example.com