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Contest Consent Form
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Contest Consent Form
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Participant Consent Form
Contest Consent Form
Contest Selection
*
If you are entering either one of the two contests being held, please acknowledge which contest you are entering and sign additional consent to having your name and/or artwork displayed.
Naming Contest
Artwork Contest
Naming Contest
Display Name?
*
Yes
- I am entering the naming contest and I grant permission to Pathway to Pimachisowin to upload my name to be virtually displayed on an online gallery platform for public display.
No
- I am entering the naming contest but I wish to remain anonymous.
Artwork Contest
Display Name?
*
Yes
- I am entering the artwork contest and grant Pathway to Pimachisowin to upload my artwork to be virtually displayed on an online gallery platform for public display. I understand my artwork is being posted online and the copying of this art is prohibited. I also understand Pathway to Pimachisowin is not liable for lost or copied art as this is the unavoidable risk of an online gallery.
No
- I am entering the artwork contest but I wish to remain anonymous
Contact Person (optional)
Contact information for a friend or family member of the artist. A copy of this form submission will be sent to the email address below if specified.
Contact Person Name
Contact Email
Contact Phone
Is the contact person able to collect the artwork?
Yes
No - someone else will need to collect it
No - it will be submitted digitally or via mail
Artist Name
*
First
Last
Artist Signature
*
Name
This field is for validation purposes and should be left unchanged.
59122
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