Thank you for your submission in the Nevada State Green Party Pupfish Drawing/Digital Art Contest. All contest entries must be accompanied by a signed copy of this release form. Entrants must be 18 years of age, a resident of the United States and reside in the State of Nevada.
I, _______________________________________(Print Entrant Name) In
exchange for good and valuable consideration, consent to the display and/or use of my original artwork submission or images thereof by Nevada State Green Party and the Green Party of the United States. This consent applies in all forms known now or in the future, in all media and in all manners, including, but not limited to, advertising, art, editorial, electronic and exhibition. I hereby release Nevada State Green Party, their affiliates, respective directors, officers, agents, employees, and guests from any and all claims of any kind on account of any such use. I understand that if my artwork is chosen as the 1 st Place or 2nd Place winner of the art contest, it will be displayed on Nevada State Green Party and the Green Party of the United States internet pages for up to two years, and that the artwork will be returned to me at the end of that period in its then current condition. After said two year period the Entrant can submit a continued release for continued use by the Nevada State Green Party and the Green Party of the United States in a separate agreement.
Entrant Information:
Name: ____________________________________________________
Address: __________________________________________________
Telephone________________________________________________
Email: ____________________________________________________
____ Initial here to verify you are over 18:
____ Check here, I the entrant on said form fully agree and understand this form.
Entrant Signature and Date__________________________________
Print Entrant Name_________________________________________