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ASLHS Media Release Form .pdf


Original filename: ASLHS Media Release Form.pdf
Title: Microsoft Word - 2018 Art Competition Packet.docx

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American Sign Language Honor Society
2018 Chuck Baird Memorial Art Competition
Student Entry Form

This sheet must be completed by the student and accompany all entries
School Name _____________________

ASL Teacher ______________________

Student Name _______________________ Email __________________________
Student Address _____________________________________________________
_____________________________________________________
Entry Title ________________________ Circle one: Reproduction / Original Creation
Entry Title ________________________ Circle one: Reproduction / Original Creation
NOTE: If Reproduction, include the website source of the original portrait artwork being
imitated below:
___________________________________________________________________
(Other acceptable forms of source information are a printed color copy or a downloaded
image included on the flash drive)
Read & Acknowledge the Following:
___
___
___

I have received minimal assistance from any outside person
I understand that if I win in any category, my artwork may be posted online
I understand that all entries become the property of the ASL Honor Society
and will not be returned.

I _________________________ (print student name) acknowledge that the entry or
entries I have submitted represent my own work and ideas.
___________________________________
____________________
Student Signature
Date
**If the student entering the 2018 Chuck Baird Memorial Competition is younger than 18
years of age, please have a parent read and sign the following:
I give my child ___________________________ (print student name) permission to
submit his/her entry to the 2018 Chuck Baird Memorial Art Competition sponsored by the
ASL Honor Society. I understand that if my child places in any category, his/her work may
be posted on the ASLHS home page (http://www.aslhonorsociety.org) and other social
media sites.
___________________________________
Parent Signature



____________________
Date


Document preview ASLHS Media Release Form.pdf - page 1/1

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