2021 IDD Awareness Theme: Leading, Learning, and Living as One First Name* Last Name* Email* Phone* Name of Central Participant* Age of Participant* Will you be using an assistant, and if so please enter their name below Role of Assistant Name of Act/Performance* Talent Category*SelectSingingPlaying Musical instrumentDancing or gymnasticsLive painting or craftingOratorical, poetry, or spoken wordMisc. (i.e. magic act, Lego building, juggling, hula hooping, pet act, roller skating, etc.)Talent Release Waiver* I have read and agree to the terms of the waiverCONSENT TO PHOTOGRAPH, FILM, OR VIDEOTAPE AN INDIVIDUAL FOR NON-PROFIT USE (e.g. educational, public service, or health awareness purposes) ORGANIZATION: The Potter’s House of Dallas, Inc. I hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, Movies, or video tapes of the individual named above by . The Potter House of Dallas, Inc. I also grant The Potter’s House Inc. the right to edit, use, and reuse said products for non-profit purposes including use in print, on the internet, and all other forms of media. I also hereby release The Potter’s House of Dallas, Inc. and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above. Video Submission Tips and Guidelines* I have read and acknowledged the video tips and guidelinesClick Here To View Video Tips And GuidelinesVideo File Submission*Video's are NOT to be longer than 2-3 minutes and no more than 300MB in size. Deadline to submit video - 5 p.m. CST, April 2, 2021Accepted file types: mov, mp4, mp3, webm, mpg, mp2, mpeg, mpe, mpv, ogg, m4p, m4v, avi, wmv, qtEmailThis field is for validation purposes and should be left unchanged.
2021 IDD Awareness Theme: Leading, Learning, and Living as One First Name* Last Name* Email* Phone* Name of Central Participant* Age of Participant* Will you be using an assistant, and if so please enter their name below Role of Assistant Name of Act/Performance* Talent Category*SelectSingingPlaying Musical instrumentDancing or gymnasticsLive painting or craftingOratorical, poetry, or spoken wordMisc. (i.e. magic act, Lego building, juggling, hula hooping, pet act, roller skating, etc.)Talent Release Waiver* I have read and agree to the terms of the waiverCONSENT TO PHOTOGRAPH, FILM, OR VIDEOTAPE AN INDIVIDUAL FOR NON-PROFIT USE (e.g. educational, public service, or health awareness purposes) ORGANIZATION: The Potter’s House of Dallas, Inc. I hereby consent to the participation in interviews, the use of quotes, and the taking of photographs, Movies, or video tapes of the individual named above by . The Potter House of Dallas, Inc. I also grant The Potter’s House Inc. the right to edit, use, and reuse said products for non-profit purposes including use in print, on the internet, and all other forms of media. I also hereby release The Potter’s House of Dallas, Inc. and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above. Video Submission Tips and Guidelines* I have read and acknowledged the video tips and guidelinesClick Here To View Video Tips And GuidelinesVideo File Submission*Video's are NOT to be longer than 2-3 minutes and no more than 300MB in size. Deadline to submit video - 5 p.m. CST, April 2, 2021Accepted file types: mov, mp4, mp3, webm, mpg, mp2, mpeg, mpe, mpv, ogg, m4p, m4v, avi, wmv, qtEmailThis field is for validation purposes and should be left unchanged.
