APPLICANT INFO:
First Name: Last Name:
Address:
City: State: Zip Code:
Daytime Phone: Evening Phone:
Member E-mail Address: Member Password:

SCREENPLAY INFO:
Title of Screenplay: Page #:
Logline (1 sentence):

Please enter the Categories you are submitting to

SERVICES & FEES:
Only Loglines or Screenplays are accepted for additional categories:
Additional Category - $5.00 Two Additional Categories (Three Total Categories) - $10.00 Three Additional Categories (Four Total Categories) - $15.00

PAYMENT METHODS:
Please include a check or money order payable to "ScreenplayFest."  Check  Money Order

RELEASE FORM: 
1. The writer(s), producer or agent (hereby known as "Writer"), agree and understand that The Philadelphia Screenplay Festival, B-Side and their operators (hereby known as "Analysts") become privy to many literary materials, scripts and ideas, and the Writer's script may be similar/identical in nature, theme, idea, plot, format and/or other respects to said materials received and/or created by the Analysts. Writer agrees to hold harmless the Analysts from any similarity between the script the Writer is submitting (hereby known as "Material") and any other script the Analysts receives, creates or has created. Writer hereby releases the Analysts from any and all claims, liabilities and demands that may be made by the Writer asserting that the Analysts has used or appropriated the Material, or any portion thereof. Writer further agrees he/she will not be entitled to any compensation because of the use by the Analysts of such similar material which may have been independently created by the Analysts or have come to the Analysts from any other independent sources. 
2. The Writer represents that the Writer is at least eighteen (18) years of age and holds all legal rights to the Material submitted for analysis. 
3. The Writer hereby acknowledges that the sole responsibility of protecting the Material belongs to the Writer, and that the Analysts strongly recommends Copyright protection and/or WGA Registration before submitting Material for analysis. 
4. The Writer agrees that no confidential relationship is established by submitting this material and acknowledges that the Analysts and its affiliates are under no obligation other than to provide analysis services. 
5. The Writer understands and agrees that literary service is a subjective service, allowing for reasonable disagreement as to the relative merits of the submission. The Writer understands that the coverage may or may not be complimentary or positive in its judgment, and that the evaluation fee is non-refundable. 
6. The Writer understands that the Analysts may retain or destroy the Material and acknowledges possession of additional copies of same. 
7. The Writer agrees that he/she is submitting Material freely, for analysis services only, not for sale or representation, or for assistance with gaining a sale or representation. The Writer further agrees that the Analysts may refuse service to anyone, at any time, for any reason. 
8. The Analysts hereby waives all interest in the submitted Material project, in any and all media, throughout the universe in perpetuity. Should the Writer choose to implement any of the Analysts' ideas or suggestions they become the full property of the Writer. 

9. Any ideas or suggestions provided by the Analysts are provided “AS IS” without warranties of any kind. Any use of the ideas or suggestions are at Writer’s sole risk.
10. The Writer understands that the Analysts will not provide services without this signed Release Form. 
Writer Signature: Date: 
Co-Writer Signature:Date: