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MEVC Submission Form

Entry Spokesperson
Date: 10/31/2014    
First Name:
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Last Name:
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Phone:
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Email:
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Classification
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College:
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Name of group/organization you are representing:
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Do you have permission to act on behalf of this group:
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Video Entry
Video Name:
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Principle Featured:
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Reason for choosing this principle:
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Summary of what the video is about:
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Web address for your video
(if applicable):
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How did you hear about the
Matador Ethics Video Challenge?

(check all that apply)
Information on Official Participants (limit of 8)
Participant 1: Participant 2:
Name:
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Email:
Required
Classification:
Required
College:
Required
Name:
Email:
Classification:
College:
Participant 3: Participant 4:
Name:
Email:
Classification:
College:
Name:
Email:
Classification:
College:
Participant 5: Participant 6:
Name:
Email:
Classification:
College:
Name:
Email:
Classification:
College:
Participant 7: Participant 8:
Name:
Email:
Classification:
College:
Name:
Email:
Classification:
College:
Permission to use video/image/testimonial data and certification of original work

I / we certify that the video submitted is our original creative work; is not offensive and does not promote illegal behavior; and does not infringe another person or group’s copyrights or privacy.

The act of submitting a video to the Matador Ethics Video Challenge, certifies that all participants in the video give Texas Tech University, Texas Tech University Health Sciences Center and/or Texas Tech University System (herein, “Texas Tech”), its employees, designees, agents, independent contractors, legal representatives, successors and assigns, and all persons or departments for whom or through whom it is acting, the absolute right and unrestricted permission to take, use my name, testimonial and biographical data and/or publish, reproduce, edit, exhibit, project, display and/or copyright photographic images or pictures of me or my child(ren), whether still, single, multiple, or moving, or in which I (they) may be included in whole or in part, in color or otherwise, through any form of media (print, digital, electronic, broadcast or otherwise) at any campus or elsewhere, for art, advertising, recruitment, marketing, fund raising, publicity, archival or any other lawful purpose.

I/we release and agree to hold harmless Texas Tech, its Board of Regents, officers, employees, faculty, agents, nominees, departments, and/or others for whom or by whom Texas Tech is acting, of and from any liability by virtue of taking of the pictures/videos or using the testimonial/biographical data, in any processing tending towards the completion of the finished product, and/or any use whatsoever of such pictures or products, whether intentional or otherwise.

I/we certify that I and all individuals depicted in the video are at least 18 years of age (or if under 18 years of age, that they are joined herein by parent or legal guardian) and that this release is voluntarily, under no duress, and without expectation of compensation in any form now or in the future.

Required

Yes

No