Superhuman Body Registration Form – Indiana

Thank you for your interest in Superhuman Body. Please fill out the following form to register for a virtual viewing of the film. Once we receive this form, a streaming link will be made available. * Asterisks represent required fields. For any technical issues, please contact screenings@macfreefilms.com.

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Today's Date

First Name

Last Name

Title

Phone

School Name

School Address

School City

School State

School Zip Code

School Phone

School District

How did you hear about the program?

If other, please specify:

Are you the main contact for this program? If not, please include the contact information (name, phone number and email) for the person who is.

Is your school public or private?

Is your school a Title I school?

Yes No

How would you like to show Superhuman Body for students?

How many screenings do you plan on having?

Enter the date or week in which you plan to show the film. If you aren’t sure yet, please enter a desired time-frame.

What grade(s) will participate in the program?

3 4 5 6 7 8 9 10 11 12

Anticipated number of students who will see the film

Are you planning on using classroom materials?

Any additional message you’d like to share? (optional)

Permissions

I agree that the Superhuman Body film shall be used only for the permitted purposes as agreed upon and for no other purpose. Permission for any additional screenings outside your school must be requested and approved in advance.

Usage

I agree that the program is not to be duplicated, sold, loaned, transferred, televised or made available online or to any other party not contained herein at any time or in any manner other than as provided for in this agreement.

For more information about the film, visit superhumanbodyfilm.com.

Made possible by the MacGillivray Freeman Films Educational Foundation with generous support from Kenneth C. Griffin and Griffin Catalyst, Richard King Mellon Foundation and the Ambrose Monell Foundation. Educator Guide developed by the Kamin Science Center (formerly Carnegie Science Center).

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P.O. Box 205 Laguna Beach,
CA 92652 U.S.A.
949.494.1055
contact@macfreefilms.com

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Superhuman Body Registration Form – Indiana

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