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SAFETY VIDEO CONTEST ENTRY FORM
To qualify for contest, all fields must be completed before uploading video.
*
Indicates required field
Title of Safety Video
*
Contact Information
Teacher's First & Last Name (Lead Producer)
*
First
Last
Names of All Group Participants (First & Last)
*
Enter all names (first & last) separated by a comma.
Grade
*
4
5
6
7
8
9
10
11
12
Name of School
*
School Street Address
*
City
*
Province
*
Postal Code
*
Country
*
Canada
United States
Phone Number
*
Phone
*
Home
Cell
Work
Teacher's Email
*
Confirm Teacher's Email
*
I agree to the Official Rules & Guidelines
*
I Agree
You must agree to the Rules & Guidelines set forth by Community Safety Net, otherwise you will not qualify for the contest.
Please ensure all information is correct before submitting.
Submit
If you have any questions, please email
info@communitysafetynet.com
or call 1-204-661-3824 (Press 0)
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