Directing Change

Release of Intellectual Rights

If you are under the age of 18, this form has to be signed by a parent or legal guardian. Forms that are not signed properly will result in the automatic disqualification of the film

Participant Name:   

School/Organization/Club Name: 

Film Category

Film Title:   

Except as to those specified intellectual property rights identified in the entry form under the section, “Permission to use Copyrighted Music and Materials,” I hereby assign, transfer, or otherwise convey to Your Social Marketer, Inc and CalMHSA, and their agents or assigns (hereafter “Directing Change Program Organizers”), all rights, titles, and interests in and to the film(s) submitted for the Directing Change Program and Film Contest, including without limitation all copyrights and other intellectual property rights therein. Furthermore, I agree that any and all of the submitted films(s) may be used, edited, reproduced, distributed and presented in any way deemed proper by Directing Change Program Organizers, its agents or assigns without additional consent, or payment to me or anyone else claiming to have a right to such payment. There is no time-limit on the validity of this release nor is there any geographic limitation on where these materials may be used, distributed or presented.

Film submissions may be used in any way, including but not limited to the following:

  • Presentation in a public theater(s) for the Directing Change Awards Ceremony
  • Educational presentations
  • Integration into social marketing campaigns and programs (e.g. posted on websites, played in movie theatres, shared through YouTube and other social media channels and broadcast on TV).

I represent and warrant that the film created for submission to the 2017 Directing Change Program and Film Contest is original and does not unlawfully infringe upon the copyright, trademark, patent or other intellectual property rights of any third party, or is in the public domain. If the video(s) created for submission to the 2017 Directing Change Program and Film Contest becomes the subject of a claim, suit or allegation of copyright, trademark or patent infringement, Directing Change Program Organizers shall have the right, in its sole discretion, to reject or otherwise disqualify the submission. I agree to indemnify and hold harmless Directing Change Program Organizers, its officers, employees, agents or assigns from and against any and all claims, actions, costs, judgments or damages of any type relating to the production or distribution of the film(s) submitted to the 2017 Directing Change Program and Film Contest.

Signatures below also certify originality of work and adherence to the Directing Change Rules and Guidelines.

Participant (please print name):
(Select your birthday in the current year, then click back in the field and edit the year)


If participant is under the age of 18: please provide legal guarding name and have guardian sign below

Parent/Legal Guardian (please print name):   

Date Signed:  

Leave this empty:

Signature arrow sign here

Signature Certificate
Document name: Release of Intellectual Rights
lock iconUnique Document ID: 3c8af12d3a5ef60df62aa53ded93436ff69f2ec7
Timestamp Audit
2015-08-17 20:00:10 PDTRelease of Intellectual Rights Uploaded by Jesse Rowe - IP