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MATERIALS RELEASE

for the
MORE THAN JUST MUD
MiNiFLiCK Contest

You must submit this form if you use photos, video or materials not owned by you in the
film.

I _________________________________________ hereby authorize the use of the material(s)

listed below, in the film ______________________________________________ made by

_________________________________ for the Raincoast Education’s “More Than Just Mud”

MiNiFLiCK Contest. Furthermore, I certify that I have the right to authorize this use and that it does

not require consent from any third party nor violate the copyright of any other person or entity.

The following is a description of my materials:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Full credit will be given to me for their use in the end credits.

The filmmaker(s) hereby agree(s) to repair, replace and restore all materials to original condition at

the time they were borrowed.

I hereby authorize the Raincoast Education Society, its employees, representatives and assigns,

the right to use, reproduce, edit, publish or distribute my materials in the film, in perpetuity, for the

purposes of education and promotion, without compensation to me.
By contributing to this film, I voluntarily assume any and all risks. To the fullest extent allowed by

law, I waive any right to seek damages or compensation from the Raincoast Education Society or

filmmaker(s) as a result of my contribution to this film.

________________________________________ Date: _________________________________
(Signature)

_______________________________________
(Printed name)

E-mail: __________________________________ Phone: ________________________________

Address: _______________________________________________________________________

If Signatory is under 18:

I certify that I am the parent or guardian of the minor whose name appears above, that I have read,
understood, and approve of the conditions of this Release, and consent to its execution by my
child/ward. I hereby guarantee completely, my child’s/ward’s Release as set forth above.

________________________________________ Date: _________________________________
(Signature of Parent or Guardian)

_______________________________________ Phone: ________________________________
(Printed name)

Address: _______________________________________________________________________

This contest is sponsored by the Raincoast Education Society with
funding from the Habitat Conservation Trust Fund.