Competition Rules The completed form must accompany your entry and submitted on or before’ the date should be changed to on or before Monday August 23, 2021. Personal Information Surname* Middle Name* First Name* Date of birth* Age* Gender* Home Street Address* Home Parish* ---KingstonSt. AndrewPortlandSt. ThomasSt. CatherineSt. MarySt. AnnManchesterClarendonHanoverWestmorelandSt. JamesTrelawnySt. Elizabeth Parent/ Guardian (Alternate Contact) Surname First Name Relation Telephone Number Entry Type* IndividualGroup If group, please complete (identify leader of group) Member's Name Member’s Date of birth (dd/mm/yyyy) Member’s Contact Number -+ Education Level (To be completed by Main Applicant & members as applicable) Member Name Name of institution Address & Telephone number of Institution -+ Entry Information Video Title* Video size and format* DECLARATION By participating in the OPO/PARI Video Competition, each applicant represents and warrants that s/he has read and agrees to be bound by the competition’s official rules. Each applicant understands that upon entering this competition they consent to the OPO/PARI’s posting of the material on their website, social media platforms and use by the OPO of the material for promotional purposes. Each entrant also affirms that the video submitted is the original work, has not been copied from others, and does not violate the intellectual property rights of any other person or entity. Signature Date of submission