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Name: _ Address: City: Phone: Attachment 9 "Thie IHattiiire of" Orainge " Contest 1' "IIPI biiyi l ba;� Illl rr,ii tl ,ay �@,jnld Fraiiulls iini Girarwe o u»uinity,' A I1 IIII of 1 ( r ii s 1) of ui by 5 U U p ]MI 1II 1I. , .2 0 1111 iii u Orange County DEAPR, 306 -A Revere Rd., PO Box 8181, Hillsborough, NC 27278 htlp:// orangecountync .gov /deapr /index.asg 919- 245 -2510 CONTEST ENTRY FORM (A separate Entry Form is required for each photograph entered) Email: IM State: Zip: Division: ❑ Youth (18 & under) ❑ Adult (please check one) *Photographs should feature: Orange County wildlife, natural resources, landscapes, or people within our parks and trails (maximum of five entries per person.) PHOTO AGREEMENT AND RELEASE Signature below affirms review and agreement with all contest rules and photo release. This agreement will apply to all photographs and other submissions supplied to DEAPR for the "Nature of Orange " Photography Contest and will remain in full force and effect until cancelled in writing by either party. Note: Signature of parent /guardian required for all entrants under the age of 18. I, hereby grant Orange County DEAPR the right to use my likeness, name, and /or images I have photographed in any and all publications, including websites without compensation. In addition, the photographer retains all rights for any other use. I hereby authorize Orange County DEAPR to edit, alter, copy, exhibit, publish or distribute all photos submitted herein to this contest and I waive the right to inspect or approve the finished product. I affirm that my entry materials are original, do not infringe on any third party's rights, and that any necessary permissions from any third party have been obtained (if a third party appears in the photograph). Name of Photographer: Signature of Photographer: Signature of parent /legal guardian (ifphotographer is under 18): Printed name of parent /legal guardian: Date: Date: