Entry Form

2. Entrant First Name*
3. Entrant Last Name*
5. Phone Number*
6. Email Address*
8. Address (If you win, we need to know where to send your prize!)*
10. City*
11. State*
12. Zip Code*
16. Is the entrant 18 years of age or older on the date this entry is submitted?*
    -- Select One --YesNo, a legal parent/guardian will sign below.
18. Publicity Release/Permission to Reprint*

    By signing below, I hereby grant permission to the City of Grand Ledge to use the photograph(s) submitted for publishing, illustration, advertising, trade and promotion, on the City’s website, Facebook page, FLIKR website, television channel, or for any other purposes or any other mediums they deem appropriate without payment or any other consideration. I understand and agree that these materials will become the property of the City of Grand Ledge and will not be returned. I hereby irrevocably authorize the City of Grand Ledge to edit, alter, copy, exhibit, publish, and distribute my photograph(s) for purposes of publicizing the City or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my photograph(s) appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my photograph(s). I hereby hold harmless and release and forever discharge the City of Grand Ledge from all claims, demands, and causes of action which, I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or of my estate have or may have by reason of this authorization. 

    1. I agree.
20. Agree to Official Photo Contest Rules*

    1. I agree.

    I have read and agree to all Terms and Conditions with the Official 2022 Photo Contest Rules.

22. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
24. Electronic Signature
28. Photo #1*

    Files should be named "PhotoName_EntrantLastName.jpg/png"

29. Does Photo #1 have any recognizable faces?*

    1. Yes
    2. No
31. Upload Model Release Form(s) for Photo #1*

    You agreed there were recognizable faces in Photo #1. Please upload a Model Release form for each person in the photo, as one PDF.

32. Would you like to upload a second photo?

    1. Yes
    2. No, I'm done.
34. Photo #2*

    Files should be named "PhotoName_EntrantLastName.jpg/png"

    
    

35. Does Photo #2 have any recognizable faces?*

    1. Yes
    2. No
37. Upload Model Release Form(s) for Photo #2*

    You agreed there were recognizable faces in Photo #2. Please upload a Model Release form for each person in the photo, as one PDF.

38. Would you like to upload a third photo?

    1. Yes
    2. No, I'm done.
40. Photo #3*

    Files should be named "PhotoName_EntrantLastName.jpg/png"

41. Does Photo #3 have any recognizable faces*

    1. Yes
    2. No
43. Upload Model Release Form(s) for Photo #3*

    You agreed there were recognizable faces in Photo #3. Please upload a Model Release form for each person in the photo, as one PDF.

    
    

44. Would you like up upload a fourth photo?

    1. Yes
    2. No, I'm done.
46. Photo #4*

    Files should be named "PhotoName_EntrantLastName.jpg/png"

    
    

47. Does Photo #4 have any recognizable faces?

    1. Yes
    2. No
49. Upload Model Release Form(s) for Photo #4*

    You agreed there were recognizable faces in Photo #4. Please upload a Model Release form for each person in the photo, as one PDF.

50. Would you like to upload a fifth photo?

    1. Yes
    2. No, I'm done.
52. Photo #5*

    Files should be named "PhotoName_EntrantLastName.jpg/png"

53. Does Photo #5 have any recognizable faces?

    1. Yes
    2. No
55. Upload Model Release Form(s) for Photo #5*

    You agreed there were recognizable faces in Photo #5. Please upload a Model Release form for each person in the photo, as one PDF.

Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field