Form Instructions
Production Agreement and 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.
- Fill in your team leader’s name, sponsoring school, and video title.
- Each person who participates in the production of your video must fill in the services
provided, read the conditions of the agreement, fill in their name and date,
sign the form, and fill in their complete address.
- If the person who participated in the production of your video is under age 18 as
of March 4, 2013, their parent or legal guardian must fill in their own name, sign
their name, and date the form.
