Qhia Dab Neeg Film Festival Entry Form
Name of Entrant(s): _________________________________________________________________________ Age: ________________ Email Address: ________________________________________________________ Address: ______________________________________________ City/State: __________________________ Phone Number: __________________________________________ Zip Code: ________________________ Film Title: ___________________________________________________ Year Completed: _____________ Running Time: ___________________________ Genre: ___________________________________________ Synopsis (200 words or less): Filmmaker’s Biography: Agreement A signed and completed agreement form must accompany each submission. A film cannot be screened without permission from submitter. Al rights to the releases necessary for exhibition of the work submitted to the public is conveyed; Qhia Dab Neeg Film Festival is not obligated to make payment to any third party. The use of film clips and materials for promotional use will not violate or infringe upon the rights of any person, firm or corporation whatsoever. I understand all materials submitted are to be retained by Qhia Dab Neeg Film Festival and may be used for future promotional purposes. These rights agreed to by the undersigned shall be non-‐exclusive to the Qhia Dab Neeg Film Festival.
Entrant’s Signature: ___________________________________________________________________ Date: ________________