Contestant's name:
Age Birthdate
Email :
Street Address :
City
State
Zip
Phone (optional)
Main Entry $10.00
Additional photos $5.00 each
Proof Contest $10.00
UNLIMITED HEADSHOTS $20.00
Total
Total # of photos
I will send my fees :
With Paypal to Picturethispc@yahoo.com
I'd rather send a money order, to the following address: Angela Smith 20 Acorn Drive Corbin, KY 40701.
Please add any comments you have below:
Release: I hereby understand By signing this entry form, that the Judges will remain anonymous and all decisions are FINAL Picture This! Photo Contest or Angela Smith is not liable for misdirected mail, postage due, or damaged photos. I also agree that I will be responsible for any money owed to the photo contest and its director. I also agree that the judge's decisions are final and bad conduct will not be tolerated and will result in disqualification. No Refunds will be given!
By signing this form I relinquish all rights to file claim against Picture
This!, or Angela Smith. By signing this entry form,I am giving permission for my child's winning photo to be used for promotional advertising related to this contest only, on or off the Internet including photo featured on website and advertisements. I also understand that prizes can be increased or decreased based on number of entries received.
Signature Date
(Parent or guardians signature required if contestant is under 18 years of age.)