Work Safe Alberta High School Student Video Contest Application Package

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1 Work Safe Alberta Application Package All entries must be received no later than Friday, March 17, 2017, 4.00 pm Page 1 of 7

2 Application Form Contest Entry Form... 3 Team Submission Information... 4 Eligibility... 5 General Information... 5 Selection of Awards... 6 Entry Information... 7 Go to for additional information regarding the High School Student Video Contest: Judging Criteria Frequently Asked Questions and Answers Checklist Am I Ready to Submit? All entries must be received no later than Friday, March 17, 2017, 4.00 pm Page 2 of 7

3 Mail or courier to: Alberta Labour 8 th Floor, Avenue Edmonton, AB T5K 0G5 Student / Project Leader Name (please print) Official Entry Form City Province Postal Code Telephone No. School Name School Address City Province Postal Code School Telephone No. Age Grade Is this submission: Individual OR Team (please list team members on Page 4) Is this entry part of a class assignment? Yes Project Title Length of Submission Teacher/School Representative (Mandatory) No If yes, please indicate during which semester this entry was completed first OR second Media Format Signature of Teacher / School Representative I have viewed the video submission. Yes No Consent and Release I, the undersigned, have read, understand and agree to abide by the Rules governing the Work Safe Alberta (as set out in this Official Entry Form) and certify that all information contained in this completed Entry Form is true and accurate. By signing this Entry Form, I irrevocably grant Government of Alberta (GOA) the right and permission to: (1) publicly disclose and use my name, address, likeness, school, age, grade and/or prize information for promotional or other purposes, without compensation; and (2) to copy, modify, play and use the video submission ( Video ) accompanying this Entry Form in whole or in part, without compensation. The Video has been originally and lawfully created by me or my team and the use, modification, play or reproduction of the Video by GOA, will not give rise to any third party claims for infringement or violation of copyright, trademark or any other right of any third party, or to any third party claims including libel, defamation, violation of privacy or contract breach. I have obtained all necessary permissions, consents, licenses, or other approvals of third parties (including, but not limited to, all individuals appearing in the Video and all holders of copyright in any copyrighted music, images or other materials used in the Video) necessary or appropriate for the preparation or use of the Video and such approvals are enclosed. I release GOA from any liability in connection with my participation in this contest, or the preparation or use of my or my team s Video and agree to indemnify GOA for any liability and all reasonable costs arising from any third party action, claim or proceeding commenced against JSTL because of the Video. I warrant that I am the owner of copyright or act with the authority of the owner to grant to GOA the non-exclusive worldwide right to use the copyright material. Signature I, the parent or guardian of the above-named minor, agree that s/he may participate in the Student Video Contest and, by signing below, hereby voluntarily join in the foregoing Consent and Release. Name (Print Name) Signature Date Date Your personal information is collected under the authority of the Government of Alberta and the Freedom of Information and Protection of Privacy Act for the purpose of the Student Video Contest. Questions regarding the collection, disclosure and use of your personal information may be directed to Cailín Mills at All entries must be received no later than Friday, March 17, 2017, 4.00 pm Page 3 of 7

4 Mail or courier to: Alberta Labour 8 th Floor, Avenue Edmonton, AB T5K 0G5 Team Submission Information Only complete if more than one person is on the Team Official Entry Form must also be fully completed and attached Student's Name- Team Leader (please print) City/Province Postal Code Telephone Signature Age Grade Date I, the parent or guardian of the above-named minor, agree that s/he may participate in the Work Safe Alberta and, by signing below, hereby voluntarily join in the foregoing Consent and Release. Name (Please Print) Signature Date Student's Name (please print) City/Province Postal Code Telephone Signature Age Grade Date I, the parent or guardian of the above-named minor, agree that s/he may participate in the Work Safe Alberta and, by signing below, hereby voluntarily join in the foregoing Consent and Release. Name (Please Print) Signature Date Student's Name (please print) City/Province Postal Code Telephone Signature Age Grade Date I, the parent or guardian of the above-named minor, agree that s/he may participate in the Work Safe Alberta and by signing below, hereby voluntarily join in the foregoing Consent and Release. Name (Please Print) Signature Date All entries must be received no later than Friday, March 17, 2017, 4.00 pm Page 4 of 7

5 Eligibility: 1. Application Forms must be fully completed or submissions will be disqualified. 2. To be eligible, your entry must be no longer than two (2) minutes in length. 3. Each contestant may only enter one original entry, either alone or as part of a team effort. 4. Each contestant must certify on the entry form, that the submission is an original work by the contestant or his/her team and must grant Government of Alberta (GOA) unrestricted use and reproduction rights for any purpose. 5. This contest is open to all high school students residing in Alberta. 6. Your entry must be entirely your (or in the case of a team effort, your team s) own original creation. It must not infringe upon or violate any laws or any third-party rights, including, but not limited to, copyright, patent, trademark, trade secret or other proprietary rights and must not lead to any cause of action including libel, defamation, privacy violation, contract breach or tort. 7. Contestants must obtain all necessary permissions, licenses, clearances, releases, waivers of moral rights and other approvals from third parties (including but not limited to all copyright holders and all individuals appearing in the video submission), necessary to use the video submission, in whole or in part, in any way, including without limitation, to reproduce, make derivatives, edit, modify, translate, distribute, transmit, publish, license and broadcast the video submission worldwide, by any means. Any and all such permissions, licenses, clearances, releases, waivers of moral rights and approvals must be attached with your entry. General Information: 8. Your own personal health and safety and the health and safety of your cast, crew and others involved with the production of the video submission must be maintained. Do not endanger anyone during the making of your video. If you are on a work site, take all appropriate health and safety precautions including without limitation following all applicable health and safety policies and regulations. You may wish to consult with a supervisor or other competent individual at the site to obtain this information. 9. No entries will be returned. All winning entries become the sole property of OHS. 10. Three prizes will be awarded in this contest. A prize of two thousand dollars ($2,000) will be awarded to the first place entry, one thousand five hundred dollars ($1500) will be awarded to the second place entry and one thousand dollars ($1000) will be awarded to the third place entry. Matching prizes are awarded to the high schools of the winning entries. All entries must be received no later than Friday, March 17, 2017, 4.00 pm Page 5 of 7

6 11. Before collecting a prize, each individual or team member involved in the creation of a winning entry, and, in the case of those individuals or team members who have not yet reached the age of majority, his/her parent or legal guardian will be required to sign a standard declaration and release form confirming compliance with the contest rules, and acceptance of the prize as awarded and assigning all rights, titles and interests in the entry to GOA (including a waiver of moral rights) within seven (7) days of being notified that his/her entry has been selected. 12. If a contestant is not 18 years old, GOA will require his or her parent s or legal guardian s authorization before permitting the contestant to participate in the contest and accept a prize as awarded. In the case of a team effort, each member of the team who is not 18 years old must also obtain parental or guardian consent. 13. When entering this contest, each contestant (and where appropriate, with the consent of a parent or guardian) must consent to the use, reproduction, publication, transmission and/or broadcasting of his/her name, address, likeness, school, age, grade and/or prize information, without compensation, in any GOA advertisement, publication or promotion, for general news or other information purposes. Winners must also consent to their photographs being taken by GOA for the same purposes, without further compensation. Each contestant (and where required, his/her parent or guardian) irrevocably and in perpetuity grants GOA, without compensation, the right to use the video submission, in whole or in part, in any way, including without limitation, to reproduce, make derivatives, edit, modify, translate, distribute, transmit, publish, license and broadcast the submission worldwide, by any means. 14. The chances of winning a prize depend on the total number and quality of eligible entries received prior to the closing date. 15. GOA reserves the right to cancel, terminate, modify or suspend the contest for any reason, without any prior notice to any contestant. Selection of Awards: 16. Entries will be judged by a panel of judges chosen by GOA. The decisions of the judges on all matters relating to the contest are final and not open to dispute. 17. Each individual or team member who submitted a winning entry will be notified by that his/her entry has won and the procedure to follow to claim the applicable prize. If an individual or one or more team members decline the prize, the prize may be forfeited and awarded to another entry in accordance with these contest rules. If GOA does not receive entries of sufficient quantity or quality, GOA reserves the right not to award any prizes. 18. In the case of a team effort, GOA will issue a cheque to school for distribution. Each winning high school will receive a matching prize equal to the total prize awarded to the team. All entries must be received no later than Friday, March 17, 2017, 4.00 pm Page 6 of 7

7 Entry Information: 19. Each contestant or team may only submit one submission in DVD-R format. Multiple entries will not be accepted. 20. Your submission must be received by GOA by 4:00 pm on Friday, March 17, You will not be contacted to confirm your submission has been received. 21. Please submit your entry by mail or courier to: Work Safe Alberta Attention: Cailín Mills Alberta Labour- Strategy and Policy 8 th floor, Avenue Edmonton, AB T5K 0G5 22. The entry must be clearly labeled with your video s title, your name, mailing address and telephone number. Where more than one student has been involved in the creation of the video, the video entry must be clearly labeled as a team effort. 23. Include your completed Official Entry Form with your video submission. If the entry is a team effort, page 4 of the Official Entry Form must also be completed and returned with your entry. If the forms are not submitted within the required timeframe or are incomplete, the entry will be disqualified 24. If any copyright or permissions, licenses, clearances, releases, waivers of moral rights and approvals were obtained, please enclose these with your video entry. GOA is not responsible for entries which are delayed, lost, misdirected, incomplete, damaged or destroyed. Any entry that is tampered with, unreadable or mutilated will not be accepted. DO NOT SEND YOUR ONLY COPY. 25. For the purpose of these Rules, each properly labeled video submission accompanied by a properly completed Official Entry Form shall be considered a valid entry. 26. These rules may be changed without notice or reason including, if necessary, to comply with any applicable law. By entering this contest, contestants agree to abide by these rules and acknowledge that GOA shall not be responsible for any damages, costs, demands, claims or losses of any kind, incurred by any contestant as a result of participation in the Work Safe Alberta High School Student Video Contest. 27. This contest shall be governed by and construed in accordance with the laws of the Province of Alberta and any applicable federal laws. These rules govern all aspects of the contest and are binding on all contestants and all other participants including parents, legal guardians and team members, who sign the Official Entry Form. All entries must be received no later than Friday, March 17, 2017, 4.00 pm Page 7 of 7

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