Entry form

Entrant name *

School name *

Postal details *

Street address *

Suburb/Town *

State *

Postcode *

Phone *

Email *

Year level *

Year 10Year 11Year 12

Electorate *If you don’t know your electorate, please visit electorate.aec.gov.au

My First Speech video *

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MP4 video format only. Maximum file size 500MB. See your school media teacher for help with converting your video to MP4 and compressing to under 500MB.

Transcript of your First Speech *You can copy and paste text from another document above.

If your entry is part of a school submission, please provide the following additional information:

Teacher name

Phone

Email

Declaration

I hereby declare that this entry is my own and that, to the best of my knowledge and belief, it contains no material previously published or written by another person or organisation. By signing this form, I acknowledge that I have read and agree to the My First Speech competition Terms and Conditions of Entry.

Entrant signature *

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Date *

Please select one *

I am over 18 yearsI am under 18 years

If you are under 18 years of age you will need your agreement co-signed by a parent or legal guardian.

Consent and release agreement

The Australian Parliament and the Department of the House of Representatives (collectively referred to in this agreement as ‘the Parliament’) aims to raise awareness of the federal Parliament among young Australians by encouraging students to voice their opinions as if they were making their first speech in the House of Representatives and by publishing and broadcasting the winning videos and all other suitable entries from the My First Speech competition.

I/we give consent for the Parliament to use and publish your/your child’s name and town/state and your/ your child’s video submitted to the My First competition (including quotations attributable to you) in electronic and printed materials, the Parliament’s websites and as part of an exhibition installation at Australian Parliament House in Canberra.
I/we are aware that information published on the internet is accessible to users all over the world and the Parliament has no control over the subsequent use and distribution of the video.
I/we understand that all copyright in the materials vests in the Commonwealth of Australia.
I/we acknowledge that you/your child is not entitled to any remuneration, royalties or payment in respect of the use of the video submitted to the My First Speech competition.
I/we give consent for the Parliament to create video recordings and photographs of me/my child as part of the competition and publish these images in online or printed form.
I/we agree to the terms and conditions for the My First Speech competition available on the entry form and on the website at www.aph.gov.au/myfirstspeech.

Name of parent/guardian

Signature of parent/guardian

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Parent/guardian email