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2. First Name*
3. Last Name*
5. Parent or Guardian (if under 18 years of age)
7. Street Address
8. Apt./Suite No.
10. City
11. State
12. Zip
14. Phone No.
15. Email*
17. Age Category*
    -- Select One --6-1213-1718+
19. DROPBOX SUBMITTAL
    Upload to Dropbox

    Please include your full name in the file name.
20. WETRANSFER SUBMITTAL
    Upload to WeTransfer

    Please submit your videos to tchan@templecity.us, and make sure to include your name in the message box.
24. ACKNOWLEDGEMENT*

    1. By submitting an entry, I acknowledge the Contest Rules (templecity.us/contestrules) and agree to the following terms:
26. I represent and warrant that all persons identifiable in the video entry have given me approval for publication and distribution (releases) of the video, which contains their image and likenesses; and that the City has no obligation to compensate these persons.
28. I grant the City the right to indefinitely retain my video entry, which will be archived into the City's digital images library and accessible to City staff.
30. I grant the City perpetually all rights of reproduction, distribution, and to display two- or three-dimensional reproductions of the video or its images in any manner, for City use, such as print ads, postcards, posters, brochures, applications, television programs, websites, and any other of distribution or display, whether print, electronic, or televised. In addition, the City may alter images and other components of the video as necessary to fit into reduced or enlarged format sizes. No compensation shall be due, except as an eligible prize winner.
32. I agree to release, defend, indemnify and hold harmless the City, its agents, officials, employees, and volunteers from and against any and all claims and liability, including but not limited to copyright, trademark, or patent infringement, arising out of my participation or association with the Face Mask PSA Video Contest, or any City publication or distribution of the video and its images. I agree to pay all costs incident to any claim, including, without limitation, attorneys’ fees.
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34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

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