Form Instructions

Materials Release Form

For the HMSA Teen Video Awards Contest, students, working individually or in teams, compete to create and produce the best public service announcements on a teen health issue.

Please complete and print this form. Submit it with all of your TVA materials according to the contest rules. Submission deadline is 4 p.m. on March 4, 2013.

Please make sure all of your TVA materials are completed.

1. Fill in your team leader’s name, sponsoring school, and video title.
2. List the copyrighted materials that you are getting permission to use.
3. The person giving you permission to use their copyrighted materials must fill in their name and the date, sign the form, and fill in their complete address.