SUBMISSION FORM (TO BE PRINTED OUT, FILLED OUT AND SENT WITH SUBMISSION)
DATE SUBMITTED:
YEAR ORIGINAL CONTENT
WAS CREATED:
DESCRIPTION OF CONTENTS:
FORMAT OF CONTENT (e.g.,
PAL or NTSC video, JPEG, MP3, etc.):
CBEATOR{S} OF THE
CONTENT OF THE SUBMISSION:
SIGNATURE(S) OF
CREATOR(S) giving PERMISSION for use in the
proposed movie and/or unlimited
application for the promotion of
World Tai Chi &
QiGong Day AND for materials to be retained:
NAME OF CLUB OR GROUP
(if applicable) and LOCATION featured
(This information will
be included in film or publicity credits if the
Submission is selected
for inclusion):
SIGNATURES OF THOSE
APPEARING IN THE SUBMISSION indicating their AGREEMENT for the use of their
image, likeness, and/or voice (add extra pages as needed):
SIGNATURE LOCATION
DATE
SIGNED
__________________________ __________________________ _______________
__________________________ __________________________ _______________
__________________________ __________________________ _______________
__________________________ __________________________ _______________
__________________________ __________________________ _______________
__________________________ __________________________ _______________
__________________________ __________________________ _______________
Mail your Submission NO
LATER THAN APRIL 4TH, 2006 to:
Diane Douglas
350 Ward Avenue, Suite 106-126
Honolulu, HI 96814
email contact regarding Submissions: endoftheday@mac.com