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Birth Matters Virginia, Birth Documentary Contest
ENTRY SUBMISSION FORM

**Until this form is completed and you hit submit, your video will not be formally entered into the contest.

Checklist before submitting:

  • Is the video posted on YouTube?
  • Is the video 4-7 minutes long?
  • Does the video support the Birth Matters Virginia mission statement?
  • Do I have signed release forms for anyone who appears in the video, anyone who’s voice is used in the video, any immediately recognizable locations, etc?
  • Do I have permission to use any music that is included, clips from other films, or other copyrighted material?
First Name:
Last Name:
Middle Initial:
Email Address:
Telephone Number:
Mailing Address:
Video URL:
Title of video:
One sentence summary of subject matter:
By checking this box I agree to let Birth Matters Virginia use, copy, distribute, and show my work in whatever way it deems necessary, understanding that they will credit me when any footage is used.

 

 
Birth Matters Virginia is a 501(c)3 non-profit organization. We have no religious or political affiliation.
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Birth Matters
PO Box 17356
Richmond, VA 23226
info@birthmattersva.org