Entry No.
To be assigned by Competition Committee
CATAWBA VALLEY CAMERA CLUB PHOTO COMPETITION - 2009
ENTRY FORM
Please complete one entry form for each photograph entered (two photos per entry allowed).
Send form(s), entry, and $10.00 entry fee to Catawba Valley Camera Club, c/o Viewmont Camera, Inc.,
2155 North Center Street, Hickory, NC 28601.
Make check payable to Catawba Valley Camera Club.
Entry Deadline: November 14, 2009
Name Age (if youth entrant)
Address City, State, Zip
Phone E-mail Address
Title of Photograph Date Photograph Taken
Description of Photograph
Division (check one): o Amateur Adult o Youth (Age 13 – 17)
o Please return my photographs. I have included self-addressed, stamped envelopes
How did you hear about the competition?
o Newspaper o Radio o Octoberfest o From club member o Other
My signature below indicates that I have read and understand the entry rules of this competition and the images I have submitted are my original work.
By signing below I give permission for any photographs of my artwork on display at the Hickory Museum of Art (HMA) to be used for publicity purposes- including, but not limited to, media coverage of the exhibition Image*ination- and release HMA and Catawba Valley Camera Club (CVCC) from liability and demands for compensation, award or other consideration whatsoever arising from or related to the appearance in such material. HMA and CVCC will not use/reproduce the image in merchandise, for the collection, or for any other direct sale. All effort will be made to contact the artist before the image is used in any publicity.
Signature______________________________________ Date______________
By signing below I give permission for any photographs of myself taken during in conjunction with the exhibition Image*ination at the Hickory Museum of Art to be used for publicity purposes- including media coverage- and release HMA and CVCC from liability and demands for compensation, award or other consideration whatsoever arising from or related to the appearance in such material.
Signature______________________________________ Date______________
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For Official Use Only
Entry No. Division
Entrant’s Name
Title of Photograph Date of Photograph
Winner: o Best of Show o 1st Place o 2nd Place o 3rd Place o Honorable Mention
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