Video Submission Form

The following program is submitted for 'Circles of Light' by

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[hereinafter 'submitter'] for distribution by Home of Poi Ltd.

Title of program /  country of origin (this will appear on the video before your clip)

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Program description / Summary:

 

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Performer/s and their titles:

 

 

I  [would/would not] like to have this entry included in the competition section of COL2010.

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Home of Poi Ltd agrees to distribute the program. The submitter agrees to provide a program on the subject noted above. The submitter licenses Home of Poi Ltd to distribute the program, at its discretion.

The submitter acknowledges that it is assuming all costs for the production of the proposed program, including the shipping cost to Home of Poi Ltd.
The submitter warrants that it has all rights to the material included in the program to be submitted. The submitter further warrants that no material in the program infringes the intellectual property rights of others or would cause others to sue for slander. Submitter agrees to hold Home of Poi Ltd harmless from any claims by third parties resulting from our distribution of the program.

This document sets forth the complete terms of this agreement. It may be amended in writing if concurred to by both parties. Any and all disputes that may arise related to the terms of this agreement will be settled by third party mediation, or if no resolution is thus obtained, by third party arbitration, through the office of a third party arbitrator, who is mutually acceptable to the submitter and Home of Poi Ltd. The arbitrator's decision will be binding on both parties, and will stand in lieu of any other recourse under law.

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Name (please type or print)

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Signature

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Organization

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Address

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City, State, Country, Zip

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Telephone

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Email

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Web site

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Video Format:________

Video Length:________