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Lakedance Film Festival

2007

Entry Form

(Film/Video)

 

 

TITLE:_________________________________________________________________

 

TOTAL RUNNING TIME:________________________________________________

 

SUBMISSION FORMAT (check one): __VHS      __DVD            __DVD-R

 

ASPECT RATIO (check one):  __4:3 __ 16:9

 

AUDIO (check one):   __ Mono        __Stereo

 

DATE OF COMPLETION:_______________________________________________

 

DIRECTOR(s):_________________________________________________________

 

PRODUCER (s):________________________________________________________

 

WRITER (s):___________________________________________________________

 

ACTORS:______________________________________________________________

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CREW: _______________________________________________________________________

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3 LINE SYNOPSES:

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DIRECTOR’S STATEMENT:

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AMOUNT ENCLOSED: $_______

 

CONTACT INFORMATION:

NAME:_________________________________________________________________

ADDRESS:_____________________________________________________________

CITY:__________________________________________________________________

STATE:________________________________________________________________

ZIP CODE:_____________

HOME PHONE:______________

CELL PHONE:_________________

EMAIL:________________________________________________________________

Please Read and Sign this Release

All Film/Video Submissions must be submitted on VHS, or DVD, or DVD-R. Submissions WILL NOT BE RETURNED! 

Films selected for the festival will be notified by email by March 1, 2007.  Those that have their films selected will have 2 complimentary passes to view their screening, and may introduce their film at the festival if they are present.

I am the sole person responsible to make the decision to enter this media material in the LAKEDANCE FILM FESTIVAL. I understand when I fill out this entry form and thereby enter this media entry in the LAKEDANCE FILM FESTIVAL, that I indemnify, release, and hold harmless LAKEDANCE FILM FESTIVAL, its managers, employees, interns, sponsors, co-sponsors, individual and institutional supporters and TOWLE COMMUNITY THEATER from any liability related to the use of my entry. I further understand that by submitting my entry to LAKEDANCE FILM FESTIVAL, I indemnify, release and hold harmless LAKEDANCE FILM FESTIVAL of any responsibility and liability, for any or all damages or losses that may occur to my entry. I am the person responsible and give my express permission to LAKEDANCE FILM FESTIVAL to exhibit my entry at events which include but are not limited to judgings, previews exhibitions, festival screenings. The entrant further agrees that all rights and permissions for any materials contained within the said entry, including all music rights, have been granted and the entrant holds harmless LAKEDANCE FILM FESTIVAL from any or all disputes or claims that may arise from these rights and permissions granted. I give my permission to exhibit my entry at the festival screenings of the award winning entries and authorize LAKEDANCE FILM FESTIVAL to retain my entry and allow LAKEDANCE FILM FESTIVAL to include my entry for any or all promotions, compilations, screenings, webcasts and exhibitions of the LAKEDANCE FILM FESTIVAL, in perpetuity and further grant the right and permission to edit and use any part of my entry to promote previous and subsequent LAKEDANCE FILM FESTIVALS.  I also understand that all submission fees are non-refundable.

 

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 Signature ( Entries will not be accepted without signature )         Date

 

Make checks or money orders payable to: Eric Alan Sera

Send your submissions to:

Lakedance Film Festival

4014 S. Wabash Avenue

Hammond, IN  46327-1219

PLEASE DO NOT SEND FIBER FILLED ENVELOPES OR BOXES