ENTRY & RELEASE FORM

2011 RADIO FROM HELL Film Festival

Please read the Rules and Regulations before entering.
Submit this form with your film.

Submit films in person or via mail by February 14th, 2011 before 5pm for consideration.
RADIO FROM HELL Film Festival, 515 South 700 East, Suite 1-C Salt Lake City, UT 84102
011
U A R Y 2 3 R D, 2
FE BR

ENTRY & RELEASE FORM

*Late entries will not be considered.
*Each submission must include the $10 Film Festival Entry Fee. (Cash only).

FILM TITLE _____________________________________________________

FILM LENGTH (MM:SS) ___________________________________________

FILMMAKER NAME(S) ____________________________________________

FILM SYNOPSIS: (50 WORDS OR LESS) ______________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

CAST / CREW: __________________________________________________

_______________________________________________________________

______________________________________________________________

PLEASE LIST THE TIME (MM:SS) AT WHICH EACH REQUIRED ELEMENTS

APPEAR IN YOUR FILM:

"DON'T YOU KNOW WHO I AM?" ____:_____

RADIO PROP _____:______

ADDRESS: __________________________________________

CITY: ______________ STATE: ___________ ZIP: ___________

DAY PHONE: __________________ NIGHT PHONE: ___________________

DATE OF BIRTH: _________________________

E-MAIL: ________________________________

By signing below, I certify that I have read and agree to all the rules of this
contest, that the submitted media is my own work with no copyright
infringements, and i agree to allow Simmons Media and KXRK (x96) to
reproduce and utilize the contents of my film for this festival as well as
future promotions.

SIGNATURE: ______________________________________________

DATE:____________________
 SUBMISSION RULES
2011 RADIO FROM HELL Film Festival

SUBMISSION RULES
1. Submission deadline is February 11, 5:00 PM, MST. No late entries will be considered.

2. A non-refundable entry fee of $10 cash is required at time of submission. No other forms of payment
accepted.

3. Submissions will be accepted at the Simmons Media main office, 515 S 700E #1C, Salt Lake City, UT 84102.
If mailing, include entry DVD in case, completed entry form and payment. Use adequate packing material: we
are not responsible for entries damaged during shipping.

4. All films must contain the following required elements:

."Don't you know who I am?" must be included as a line of dialogue and must be used verbatim. However, it
may be included as text on-screen if the film contains no spoken dialogue.
.A radio must be seen on-screen and handled by a primary character.
The times when the required elements appear in the film must be included on the proper line of the entry
form. If an element appears multiple times, only notate the first instance.

5. All submissions must be submitted on a DVD, formatted to 16X9 aspect ratio, in DVD and/or a QuickTime
compatible format. HD files are admissible, but no blu-ray discs. Submissions in inaccessible formats will be
disqualified.

6. Films may be a maximum of 5 minutes in length, including credits. Five additional seconds of black before
and after the film are acceptable and encouraged.

7. Each film entry must be categorized by the filmmaker as Drama or Comedy. Documentaries may be submit-
ted but must be entered in either the Drama or Comedy category, whichever is more appropriate.

8. All films must contain original content (including all video, dialogue, sound and music elements) for which
the filmmaker holds copyright or an applicable license for use. Any films containing copyrighted material for
which no license can be provided will be disqualified.

9. Films will be judged based on technical quality, writing, performance, and use of required elements.

10. Awards will be given for Best Comedy, Best Drama, Best Overall and Audience Choice.

11. All awards and prizes are subject to the Simmons Media Group “General Rules for all contests”, as specified
below.
 GENERAL RULES FOR ALL CONTESTS
2011 RADIO FROM HELL Film Festival

GENERAL RULES FOR ALL CONTESTS

SIMMONS-SLC, LLC OFFICIAL CONTEST RULES (AS OF 02/09)

1. Each contest is open to all qualified persons 18 years or older except the following:
a. Employees of Simmons Media Group and related companies; household members, siblings,and parents of said Simmons employees;
b. Employees of all Salt Lake Metro area broadcasting companies, and their immediate family members; There is no purchase necessary.

2. A total of one prize may be won per household address, name, and or family residing in same, per contest, whether the prize be in cash,
services, or merchandise.

3. Persons who have previously won a prize of either cash, services, or merchandise from any of the Simmons Media radio stations (KZNS, KXRK,
KJQN, KEGA, KYMV, KOVO, KEGH), either from a contest or a station event, are subject to the following restrictions: Persons who have won a prize
valued up to $100 in the last 30 days are not eligible to win. Persons who have won a prize valued between $101 and $499 in the last 90 days are
not eligible to win. Persons who have won a prize valued between $500 and $999 in the last 6 months are not eligible to win. Persons who have
won a prize valued at $1,000 or more in the last 12 months are not eligible to win. These restrictions also apply to immediate household members
of contest or prize winners.

4. The winner will be responsible for all tax liability associated with winning this contest and will be required to submit their social security
number for tax reporting for values over $600. Winner will be required to sign an eligibility release form and give Simmons Media and its
sponsors permission to use their name, photo and voice for promotional purposes without further compensation. By accepting prize, winner
releases Simmons Media, all stations and all participating sponsors from any liability as a result of this prize. Simmons Media reserves the
right to substitute prizes of similar or greater value. Simmons Media shall not be responsible to replace prize tickets to events, which are
cancelled and the event sponsors do not issue replacement tickets. Simmons shall not be responsible for any Product Liability issues. Winners
must address Product issues with the manufacturer of the prize.

5. Simmons Media is not responsible for misdirected or mis-dialed phone calls. In the unlikely event that 2 or more people are on the telephone
line at the same time, a drawing will be held to determine the winner.

6. Copies of these rules are available at Simmons Media Group, 515 S. 700 E. #1C, Salt Lake City, Utah, 84102 10:30 am to 5:30 pm; or by mailing
a self-addressed, stamped envelope. A condensed version of the Contest Rules will be aired on the radio station during the respective contest
period. Contest rules are also posted on station web sites where available.

7. All decisions by the judges and/or administrators of the contest are final.

8. Prizes will not be awarded until winner has been verified for eligibility through the Simmons Media.

9. Business Office. Verification may take up to 3 weeks. Prizes must be claimed in a timely manner. Prized not picked up within 30 days will be
considered abandoned. Some prizes may expire. Simmons will not be required to replace expired items. Office hours for prize pickup are 10:30
am to 5:30 pm Monday through Friday at the address listed in #6.

10. Prizes are non-transferable and will be awarded to the winner only, based on eligibility. Picture ID is required in order to claim a prize.

11. Prize will not be mailed. Winner must pick up prize in person and sign proof of receipt and contest rules.

12. Winner must be a legal resident of Utah, Wyoming or Idaho. 13. Contest rules may be modified by Simmons Media at any time.
.