AMV Contest

Registration





CONTACT INFORMATION

First name *

Your given name or common name

Last name *

Your family name or surname

Email *

A valid email address so we can contact you

Phone

Your preferred phone number

Date of Birth

Your date of birth

Address:

City

Province *

(Or state)

Postcode

(Or zipcode)

Country *

Note: If you reside outside of Canada/US then please use the Additional Information box at the end of the form to add any phone numbers that won’t fit into the preformatted boxes above. Thanks!

Entry Information

Name/Studio *

(to appear in credits)

Entry 1

Video Title *

(to appear in credits)

Music/Song Title *

(to appear in credits)

Music/Song Artist *

(to appear in credits)

Duration *
minutes seconds
(min/sec)

Source Footage: *

(if more than 3, enter various)

Elements: *

(select your top 4 in order of preference)

Delivery URL *

Please provide the address including http:// or https://

Entry 2

Video Title * (if 2nd entry)

(to appear in credits)

Music/Song Title * (if 2nd entry)

(to appear in credits)

Music/Song Artist * (if 2nd entry)

(to appear in credits)

Duration * (if 2nd entry)
minutes seconds
(min/sec)

Source Footage: * (if 2nd entry)

(if more than 3, enter various)

Elements: * (if 2nd entry)

(select your top 4 in order of preference)

Delivery URL * (if 2nd entry)

Please provide the address including http:// or https://

Additonal Information

Additional Information:

If you have any other additional information, please provide it here:

Signature of Entrant

By signing you agree to abide by the contest rules and any event policies.
applicable to the contest.

In submitting this form, I hereby certify that all the above information is correct and the music video entries submitted is the creations/own
work of the video creator(s) as named on this form.

Signature *