Poetry and Art Contest for Kids in Foster Care

Sponsored by: Child Advocates, Inc.Awards presented (to selected winners) at

“An Evening with Child Advocates”April 28, 2016

6:30PM-7:30PM Indianapolis Artsgarden

Submissions will be reviewed and winners will be contacted. Poetry winners will be asked to read poems at event and winning artwork will be displayed.

Submission Deadline: March 28, 2016All entries must be original creations by submitting child.

Poetry & Art ContestEntry Form

(Please include with each entry)Send to: Nikita Garner Child Advocates, Inc. 8200 Haverstick Rd. Suite 240 Indianapolis, IN 46240 nikita@childadvocates.net (for poetry entries only)

For more information call: Nikita at 317-205-3055, ext. 2227

Contestant Name: _______________________________________________

Age:___________

Grade:__________

You can enter both poetry & art contests

Poetry ____Yes _____No Title of poem:______________________________

Art ____Yes ____ No Title of Art : _______________________________

Name of Parent/Guardian/Foster Parent: _____________________________________________

Cell: __________________________________

Home:_________________________________

Email:_________________________________

RELEASE:

With respect to the poetry and/or art (hereinafter referred to as “art”) prepared and entered into this contest by the contestant named above, Child Advocates, Inc. is hereby irrevocably granted the unrestricted right and authority to:

a) Reproduce, copy, modify, create derivatives in whole or in part, or otherwise use the art or any part thereof in combination with or as a composite of other matter, including, but not limited to, text, data, images, photographs, illustrations, animation and graphics, video or audio segments of any nature, in any media or document, now known or hereafter to become known, including, but not limited to, all formats of computer readable electronic magnetic, digital laser or optical-based media for any purpose whatsoever; b) Use and permit to be used the contestant’s first name and age; andc) Display, perform, exhibit, distribute, transmit, or broadcast the art by any means now known or hereafter to become known; andd) Share the art and any images thereof with the Marion County Department of Child Services to be used in thank-you cards.

Contestant’s signature________________________________________________Date____________________

Name of Parent/Guardian/Legal Custodian__________________________Date______________________(If contestant is under 18 years of age)