|
Everyone’s River – Everyone’s Art Entry Form
All entries must be delivered to the Pendleton Center for the Arts, 214 N. Main St., Pendleton, OR, on August 9, 2008 between 9:00 a.m. and 4:00 p.m. unless other arrangements have been made with the Center’s staff.
Important! A complete entry form must be attached to artwork. Scotch tape works well; Paperclips and staples are not allowed. Also, print your name, & grade on the back of your work. Name must not appear on front of piece.
Student’s Name: _____________________________________ Grade: _____ (2007- 08 school year)
Grade categories: K-3, 4-5, 6-8, 9-12 (circle one)
Painting: ___ Drawing: ____, Photography: ____, Ceramics: _____, Textile, Multi-Media: _____, Poetry, Prose: ___ (Check one) you may illustrate your poem or incorporate poetry into your art but you must decide which category you want the work to be judged.
Title of the artwork or poem: (optional) ______________________________________________
Pledge of Originality: I declare and avow that the poem or art I am submitting to the Everyone’s River-Everyone’s Art contest is my own original work.
Student’s Signature _______________________________________________________
Note: If you are entering through your school, scout troop, summer camp, park district, or other organization, please complete the information below. We would like to acknowledge your teacher and school/group.
School/ Organization ___________________________ Teacher ____________________
I hereby grant and assign to the Pendleton Center for the Arts (PCA) the non-exclusive right and permission, in respect of the original work that my child has submitted to Everyone’s River-Everyone’s Art (ER-EA), to use publish, and otherwise reproduce; and to use my child’s name to identify the author of the work in connection with their participation in the ER-EA contest. I hereby release and discharge the PCA from any and all claims and demands arising out of or in connection with the use of the original work, including without limitations any and all claims for libel or invasion of privacy. The PCA assumes no responsibility for lost or damaged work. This release shall be binding upon me and my heirs, legal representatives, and assigns. As the parent or guardian of the above-named minor, I hereby consent to and join in the foregoing release and consent on behalf of said minor. And, I declare and avow that the poem or art said minor is submitting to the Everyone’s River-Everyone’s Art contest is his/her own original work
Parent/Guardian’s Name (Print) ________________________________________________________
Parent/Guardian’s Signature _______________________________________ Date: ______________
Address____________________________________________________________________________
City ______________ State____ Zip Code ___________________
Phone____________________ Email: _____________________________________
|