Contest Application
Download Contest Application form
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Name |
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Zip Code |
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Age |
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Relationship to Person With Disease |
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Disease |
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Contact Phone Number |
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Contact Email |
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Art Work Title |
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Dimensions |
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Medium |
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| All works submitted must be original artwork created exclusively by the entrant. The artist's name and art may be used in promotions, publications/electronic media or exhibitions carried out by the Kakkis EveryLife Foundation. A completed entry form warrants a participant’s work is his or her own creation and does not infringe upon other copyrighted works. |
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| Work must be accompanied by an artist's brief statement (250 words or less) offering insight into the work and their experience as an artist affected by a rare disease. For Children 11 and under, the parent or guardian may submit statement. Please attach statement to entry form. |
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| Please read contest rules and sign this form: |
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| AGREEMENT: I, hereby agree: |
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- This submitted work is the creation of the artist and does not infringe upon the copyrights of artists, photographers or other entities. All artwork must be signed by artist on the front or back.
- If chosen as a grand prizewinner, the winner will grant to The Kakkis EveryLife Foundation the rights to use and publish art in advertising, promotions and other means deemed appropriate by Kakkis EveryLife Foundation. Kakkis EveryLife Foundation reserves the right to edit, modify, adapt, copyright, publish, use and reproduce the winning entries without further compensation. The Kakkis EveryLife Foundation reserves the right to install selected artwork in any manner deemed necessary for exhibition or security reasons.
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| SIGNATURE: DATE: |
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| If artist is under the age of 18, the signature of a parent or guardian must also be included on this agreement: |
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| SIGNATURE: DATE: |
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| Name: Relationship: |
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| If you are submitting your representative print via email, you may scan your signed document (PDF), and attach to your submission. Email: [email protected] |
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| DEADLINE: Entries must be received by 5pm on Friday October 30, 2009. |
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| Upload Art Work |
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| (The Upload tool supports image files only. Please select an image with one of the following formats: PNG, GIF, JPEG, BMP.) |
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