FLMS Photography & Short Film Contest Entry Form

You may submit both photos and short films via this same entry form. Limit 5 photos and 2 short films per person. If you submit less than the limit in either category and want to add more (up to the limit), you will need to fill out the form again submitting only your new entries. Your entries will be combined up to the limit. Any files exceeding the limit will be taken in the order in which they were received.

Contact Info

After reading the FLMS Official Photo Contest Rules, please complete the following submission form. All photo & film entries plus complete entry forms & releases must be submitted to FLMS by August 19, 2023, 5:00 PM, EST.

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Please select your age category. *

• Adult
• College
• High School
• Middle School
• Elementary

** Entrants under 18 years of age must have parent or guardian complete the Parent/Guardian Release Form form which will appear below upon selecting High, Middle or Elementary categories.**

Photo Submissions

Photo 1 Title

Photo 1 Date

Photo 1 Location

Photo 2 Title

Photo 2 Date

Photo 2 Location

Photo 3 Title

Photo 3 Date

Photo 3 Location

Photo 4 Title

Photo 4 Date

Photo 4 Location

Photo 5 Title

Photo 5 Date

Photo 5 Location

Short Film Submissions

Film 1 Title

Film 1 Date

Film 1 Location

Film 2 Title

Film 2 Date

Film 2 Location

Attach Photos & Short Films *

Click or drag files to this area to upload. You can upload up to 7 files.

Please name your files the same as your Photo or Film Title

Anything else we should know?

Permissions & Certifications

I certify that (1) I have read and agree to the 1st Annual Photo and Short Film Contest Official Rules (Official Rules can be obtained by emailing maryann@flms.net); (2) I am in compliance with the Official Rules; and (3) I am not affiliated with FLMS or an immediate family member of any FLMS employee. I represent and warrant that (1) I own all rights, title, and interest in and to the photos/videos submitted, (2) they are my original work, (3) they do not infringe the intellectual property or other rights of any other person or entity, and (4) I have all of the necessary rights and authority to submit photos/videos. I understand by submitting photos, I grant FLMS an unlimited license to publish and display the photos/videos, along with my name and information about the photos/videos, on organizational websites, without further compensation, and to make copies of the photo for archival and organizational fundraising and promotional purposes. I understand submitted photos/videos will not be returned and become the property of FLMS. *

• I have read official rules and agree to the above statements.

I understand submitted photograph(s)/video(s) may be used fund-raising activities and social media posts to support FLMS’ mission. I understand I will retain ownership of the work itself and all rights to its publication. I give FLMS permission to use my photograph(s)/video(s) and to identify me by name, in all forms, manner and media, including but not limited to, display, illustration, advertising, promotion, electronic transmission, printing, promotion for other FLMS purposes. For these purposes, I relinquish my personal rights of privacy release FLMS from any liability for the aforesaid use. *

• I have read official rules and agree to the above statements.

Signature *

Clear Signature

Today's Date *

Adult Model Release

In consideration of my engagement as a model, upon the terms herewith stated, I hereby give to The Florida Lake Management Society, its heirs, legal representatives and assigns, those for whom The Florida Lake Management Society is acting, and those acting with its authority and permission: a) the unrestricted right and permission to copyright and use, re-use, publish, and republish photographic portraits or pictures of me or in which I may be included intact or in part, composite or distorted in character or form, without restriction as to changes or transformations in conjunction with my own or a fictitious name, or reproduction hereof in color or otherwise, made through any and all media now or hereafter known for illustration, art, promotion, advertising, trade, or any other purpose whatsoever. b) I also permit the use of any printed material in connection therewith. c) I hereby relinquish any right that I may have to examine or approve the completed product or products or the advertising copy or printed matter that may be used in conjunction therewith or the use to which it may be applied. d) I hereby release, discharge and agree to save harmless The Florida Lake Management Society, its heirs, legal representatives or assigns, and all persons functioning under its permission or authority, or those for whom it is functioning, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form whether intentional or otherwise, that may occur or be produced in the taking of said picture or in any subsequent processing thereof, as well as any publication thereof, including without limitation any claims for libel or invasion of privacy. e) I hereby affirm that I am over the age of majority and have the right to contract in my own name. I have read the above authorization, release and agreement, prior to its execution; I fully understand the contents thereof. This agreement shall be binding upon me and my heirs, legal representatives and assigns. *

Clear Signature

Sigature

Minor Model Release

For valuable consideration, I hereby confer on the Florida Lake Management Society, Inc. the absolute and irrevocable right and permission with respect to the photographs that it has taken of my minor child in which it may be included with others: a) To copyright the same in the Florida Lake Management Society, Inc’s name or any other name that it may select; b) To use, re-use, publish and re-publish the same in whole or in part, separately or in conjunction with other photographs, in any medium now or hereafter known, and for any purpose whatsoever, including (but not by way of limitation) illustration, promotion, advertising and trade, and; c) To use my name or my child’s name in connection therewith if it so decides. I hereby release and discharge the Florida Lake Management Society, Inc. from all and any claims and demands ensuing from or in connection with the use of the photographs, including any and all claims for libel and invasion of privacy. This authorization and release shall inure to the benefit of the legal representatives, licensees and assigns of the photographer as well as the person(s) for whom it took the photographs. I have read the foregoing and fully understand the contents hereof. I represent that I am the [parent/guardian] of the below named model. For value received, I hereby consent to the foregoing on its behalf. *

Clear Signature

Sigature

Parent/Guardian Release Form: A parent/guardian granting permission of person who is under 18 years of age must complete the following. I,

of Address

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

The parent of

do hereby agree to all of the provisions of the above release on behalf of my son/daughter/ward.

Clear Signature

Parent/Guardian Signature

Today's Date

Submit