SUBMISSION FORM FILM TITLE: _______________________________ TEAM/DIRECTOR NAME: ____________________ POINT OF CONTACT NAME: _________________________ PHONE:___________________________ EMAIL: _________________________________

WEBSITE: _____________________________

DIRECTOR: ______________________________

WRITER: ______________________________

PRODUCER: _____________________________

DOP: _________________________________

SOUND (LOCATION): ______________________

EDITING: ______________________________

(________): ____________________________

(________): ___________________________

(________): ____________________________

(________): ___________________________

LEAD (CHARACTER / REAL): ____________________ / ____________________ SUPPORTING (CHARACTER / REAL): ____________________ / ____________________ SUPPORTING (CHARACTER / REAL): ____________________ / ____________________ SUPPORTING (CHARACTER / REAL): ____________________ / ____________________ SUPPORTING (CHARACTER / REAL): ____________________ / ____________________ I AM DULY AUTHORIZED TO SUBMIT THIS FILM TO SHORTLANDS FILM COMPETITION. I HAVE READ AND UNDERSTOOD THE SUBMISSION GUIDELINES AND PROCEDURES AND AGREE TO COMPLY WITH THEM IN ALL RESPECTS. TO THE BEST OF MY KNOWLEDGE ALL OF THE INFORMATION IS CORRECT. I CERTIFY THAT THE SUBMISSION HAS BEEN PRODUCED WITHIN THE TIMEFRAME DESIGNATED BY SHORTLANDS. I CERTIFY THAT ALL RIGHTS AND CLEARANCES HAVE BEEN OBTAINED AND THAT THIS FILM IS NOT SUBJECT TO ANY LITIGATION AND IS NOT THREATENED BY ANY LITIGATION. I WILL NOT WITHDRAW THE FILM FROM THE SHORTLANDS FILM COMPETITION AFTER I HAVE BEEN NOTIFIED OF ITS SELECTION. I HOLD SHORTLANDS HARMLESS FROM DAMAGE OR LOSS OF THE PRINT OR TAPE EN ROUTE TO AND FROM THE SCREENING EVENT. I AGREE AND UNDERSTAND THAT SHORTLANDS MAY WITHDRAW AND DISQUALIFY THE FILM FOR ANY AND ALL REASONS AND WITHOUT NOTICE AT ANYTIME BEFORE OR AFTER SCREENING, AND ANY PLACEMENT CAN BE RETROACTIVELY WITHDRAWN. I AGREE FOR A SHORT EXTRACT, OR THE ENTIRETY OF THE SUBMISSION, TO BE USED IN A RADIO, TV, PRINT, VIDEO PROGRAMME, WEBSITE HOSTING, OR CINEMA TRAILER FOR THE SHORTLANDS COMPETITION. I HEREBY IRREVOCABLY AND UNCONDITIONALLY WARRANT, CONFIRM AND AGREE: TO INDEMNIFY SHORTLANDS AND TO KEEP SHORTLANDS FULLY INDEMNIFIED FROM AND AGAINST ALL ACTIONS, PROCEEDINGS, COSTS, CLAIMS, DAMAGES AND DEMANDS HOWEVER ARISING WITH RESPECT TO ANY ACTUAL OR ALLEGED BREACH OR NONPERFORMANCE OF THE UNDERTAKINGS, WARRANTIES OR OBLIGATIONS UNDER THIS AGREEMENT.

SIGNATURE ________________________________ PRINT NAME _______________________________

DATE ________________

SHORTLANDS SUBMISSION FORM.pdf

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