(Please complete and submit with your film on Monday)


I, __________________________________________, team leader/producer for __________________________________________________________, a team participating in the (your city)


72-Hour S h o r t Film Challenge, hereby certify that all creative work on our film, (film title), including all writing, shooting and editing, occurred during the official 72 hour time period beginning Friday at 4 p.m. Local time and ending on Monday by 4:00 p.m. local time.



Signature Printed Name Date