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Applicant Information
Name: _____________________________________________________________
Age: ____________________________________________________________ ___
Address: ____________________ ________________________________________
____________________________________________________________________
County (circle one):
Phone Number: (
Oakland
)
Macomb
Wayne
-__________
School Email: _________________________________________________________
Twitter handle @___________________________
Education Information
School: ______________________________________________________________
School Address: ____________________________________________________ __
___________________________________________________________________ _
Major (if applicable): _________________________________________________ _
Grade/Year: ________________________________________________ _________
School Twitter handle: @______________________________________________ _
Teacher Sponsor Name: _______________________________________________ _
Teacher Sponsor Email: _______________________________________________ _
Please submit all forms via email, fax or mail by Thursday, June 4
Email [email protected] or fax to Kristin Shaw (313.877.8800)
with subject line “30/60 Video Scholarship” or mail to
Kristin Shaw, Cobo Center, 1 Washington Boulevard, Detroit, MI 48226
Cobo Center 30/60 Video Scholarship Release Statement
CONDITIONS OF PARTICIPATION: By participating in this scholarship challenge, applicant
(and applicant's parent or legal guardian if Submitter is a minor) agree (and agree to confirm in
writing) (a) to release Cobo Center from any and all claims, damages or liabilities arising from or
relating to such applicant's participation in the scholarship challenge; and (b) applicants waive
all rights to claim, punitive, incidental, consequential, or any other damages. If a finalist/winner is
found to be ineligible or not in compliance with these Official Rules, the scholarships(s) may be
forfeited and an alternate winner may be selected.
Submissions cannot defame, misrepresent or contain disparaging remarks about Detroit, Cobo
Center or its services, products, or people. Cobo Center reserves the right to and will, monitor or
screen submissions. By providing a submission, you agree that your submission may be posted
on Cobo Center-related websites, social media channels, internal and external communication,
in Cobo Center's sole discretion. Cobo Center has no obligation to use or post any submission
you submit. By providing a submission, the applicant grants to Cobo Center, an exclusive,
perpetual, transferable license to copy, publish, broadcast, display, distribute, use, edit,
translate, alter, combine with other material, reuse and adapt any or all portions of the
submissions in any way and for any purpose whatsoever, at any time, now or in the future, in
any media now known or hereafter devised throughout the world in any manner whatsoever and
for any purpose. Submissions that are not in accordance with the guidelines as stated herein or
are not received during the contest submission period will be ineligible. Submissions cannot (a)
be sexually explicit or suggestive, violent or derogatory of any ethnic, racial, gender, religious,
professional or age group, profane or pornographic, contain nudity or any materially dangerous
activity; (b) promote alcohol, illegal drugs, tobacco, firearms/weapons (or the use of any of the
foregoing), any activities that may appear unsafe or dangerous, or any particular political
agenda or message; (c) be obscene or offensive, endorse any form of hate or hate group; (d)
contain trademarks, logos or trade dress owned by others, or advertise or promote any brand or
product of any kind without permission, or contain any personal identification, such as license
plate numbers, personal names, email addresses or street addresses without permission; (e)
contain copyrighted materials owned by third parties other than the applicant (f) contain
materials embodying the names, likenesses, photographs, or other indicia identifying any
person, living or dead, without permission; and (g) depict, and cannot itself be in, a violation of
any law. By submitting a submission you warrant and represent that it: (a) is your team's original
work, (b) has not been previously published, (c) has not received previous awards, (d) does not
infringe upon the copyrights, trademarks, rights of privacy, publicity or other intellectual property
or other rights of any person or entity; (e) that you/your team have obtained permission from a
person who is used in the submission or whose name, likeness or voice is used in the
submission, if any, and (f) that publication of the submission via various media including online
posting, will not infringe on the rights of any third party rights. Any such submitter will indemnify
and hold harmless Cobo Center. Any applicant whose submission includes likenesses of third
parties or contains elements not owned by the applicant (such as, but not limited to, depictions
of persons, buildings, trademarks or logos) must be able to provide legal releases for such use
Any submission that, in the sole opinion of Cobo Center, is deemed to be inappropriate for
publication is ineligible. Incomplete, illegible, false, deceptive or garbled submissions are not
eligible.
All submissions become the sole property of Cobo Center, and will not be acknowledged or
returned. By submitting a submission, you agree that your submission is gratuitous and made
without restriction, and will not place Cobo Center under any obligation that Cobo Center is free
to disclose or otherwise disclose the ideas contained in the submission on a non-confidential
basis to anyone or otherwise use the ideas without any additional compensation to you. You
acknowledge that, by acceptance of your submission, Cobo Center does not waive any rights to
use similar or related ideas previously known to Cobo Center, or developed by its employees, or
obtained from sources other than you.
____________________________________
_
Name of Applicant
____________________
Date
____________________________________
Signature of Applicant
If under 18, the following statement must ALSO be signed by applicant’s parent/legal
guardian. I am the parent or legal guardian of the applicant. By submitting this video entry
form, I represent that I understand the Release Statement governing this contest and agree to
be bound by it.
____________________________________
Name of Applicant’s Parent/Legal Guardian
_
____________________________________ _
Signature of Applicant’s Parent/Legal Guardian
____________________
Date
Cobo Center 30/60 Video Scholarship Talent Permission Form
I consent to the videotaping/photographing of myself and the recording of my voice. I consent to
the use of these video images/photographs and/or recordings by themselves or in conjunction
with other video images/photographs and/or recordings for advertising, publicity, or other
business purposes. I further consent to the reproduction and use of these items. I release Cobo
Center, its employees and vendors from all claims of every kind based on such use.
_________________________________
Model's Printed Name
_____________________________________
Model's Signature
If model is under 18 years of age:
I, _______________________, am the parent/legal guardian of the individual named above,
have read this release and approve of its terms.
______________________________
Parent/Guardian Print Name
_______________________________
Parent/Guardian Signature
____________________
Date
This signed consent form must be submitted for everyone appearing in a Cobo 30/60
Video Scholarship challenge entry. Email questions to [email protected]