Name *

First Name

Last Name

Phone

(###)

###

####

Volunteer Interests?

Reading Scripts

Screening HollyShorts Films

Screening Films

Video Testimonial

Summit+ Moderator

Shifts @ The In-Person Summit

Summit Missionaries

Supporting Event Administration

OTHER

Release of Image *

I authorize Seattle Film Summit to publish images and/or videos taken of me and/or the minor children and guests who accompany me, as well as our names, for use and publication by Seattle Film Summit in its company website, publications and social media, including printed materials. I attest that I have the authority to authorize Seattle Film Summit to use the images and names. I understand that participation in such publications by Seattle Film Summit requires that I release Seattle Film Summit from an expectation of confidentiality for the minor children and myself.

I agree to the terms and the conditions above

Liability Release and Damage Waiver *

I release Seattle Film Summit and its employees and directors from liability for any claims in connection with my participation or the participation of the guests and minor children I bring to the event. I understand that Seattle Film Summit, is not responsible for me, including any injury or damage to my property, or myself while I am participating 2021 Seattle Film Summit. I promise not to sue or bring claim against Seattle Film Summit or its directors, officers, agents or employees for any claims, injuries or damages that may occur as a result of my participation in the 2020 Seattle Film Summit. I hereby release, hold harmless and indemnify each of the above parties from any and all liability or loss of any kind or nature, known or unknown, resulting from my participation in the 2021 Seattle Film Summit, including, without limitation, liability or loss arising from the negligence, omission or failure of any of them to exercise reasonable care or diligence.

I agree to the terms and the conditions above