Dallas Black Film Festival
Director Name___________________________________
Company_______________________________________
address_______________________________________
City__________________State___zip____________
Phone_____________fax_____________ email: ________________________
Producer Name___________________________________
Company___________________________________
address____________________________________
City_________________State____zip____________
Phone____________fax_____________email:____________________________
FILM Information
country or origin__________________
year of copyright__________________
Film Title:__________________________________Running Time___________
Genre (circle all that apply)
Drama Comedy Romance Action-Adenture True Story Animation Experimental
Other______________________
Release form
All films must be formatted in VHS or DVD.
All films must have or be of african subject matter. By submitting__________________
(film title), the undersigned warrants that (s) he has the right to submit and exhibit the above
indicated film and will indemnify and hold harmless the (Dallas Black Film Festival, People
With A Message Production Filmworks & Etc (PWAMP), Words and Deeds, and all of
it's members, staff and volunteers against any and all claims arising out of Dallas Black Film
Festival exhibition and promotion of said film should such film be prgrammed as part of the
Dallas Black Film Festival.
_____________________________________ _________________________
signature Date
_____________________________________ _________________________
Print Name Title
Returned Print to:
Name______________________________
Company___________________________
address_____________________________
City__________________State_________zip___________
phone_________________fax___________email:_________
Dallas Black Film Festival - dallasblackfilmfestival@gmail.com 972-285-7540
Owner: Yes__________No__________
