Georgia River of Words 2021 Student Entry Form
Contest Deadline: February 1
Your River of Words submission must be original and created by you alone.
Prefer not to say
Type of submission
Title of Submission
For artwork, what medium did you use? (acrylic, pencil, pastel)
File upload. Attach your art or poetry entry here. Files must be less than 5MB. Allowed file types: jpg, jpeg, png, pdf (only one file per form)
Parent/guardian phone number
Street Address Line 2
State / Province
Postal / Zip Code
Student Pledge of Originality: I declare and avow that the artwork, photos, writing or poem that this student is submitting to the River of Words competition is original work and that no other individual or parties hold copyright interest in the work and that the submission of the work does not violate any third-party rights are applicable laws.
I consent to the Pledge of Originality
Entry information: if you created your entry as an assignment in school, with a group such as scouts or with any other group or organization with a teacher or leader, select Group Entry (and enter school/organization information below). If you created your entry without an assignment or leadership, then enter as an individual (school information not necessary).
Group entry (created by one student as part of a class or group project/assignment)
Individual entry (not associated with a school or group)
School/Organization City, State
Teacher/Educator Email Address
2nd Teacher/Educator Name (if more than one)
2nd Teacher/Educator Email Address (if more than one)
Legal: Parental Consent to Publish Art/Poetry: I hereby certify and covenant that I am the legal guardian or parent of the student named above (“Student”). As the legal guardian or parent of the Student, I hereby grant and assign to River of Words (“ROW”) the non-exclusive right and world-wide royalty free and perpetual license, in respect to the original artwork, writing, poem(s), photos or video submitted on behalf of the Student, to ROW, to perform, publish, display, distribute, or use the same, individually or in conjunction with other original artwork, writing, poem(s), photos, and video, in any and all media now or hereafter known throughout the world, for any purpose whatsoever, and to sublicense to third parties these same rights, whether for a fee or otherwise. I represent and warrant that the works being submitted are the original works of the Student and such works do not infringe upon the rights of any third party.
I consent to publish art/poetry
Legal: Consent to Use Student’s Information: I consent to the use of the Student’s name, likeness in picture, video, or audio recording, and geographic location (city and state/country) to identify the author of the work in connection with the Student’s participation in the ROW contest. I understand that any use of submitted work may include the Student’s name as its creator and the city and state/country where the Student resides, and may also include an identifiable likeness of the Student in picture, video, or sound recording; and I hereby give consent for the publication and use of this personal information, and consent to such use without compensation of any kind for the Student or myself, other than the privilege of Student’s participation in the ROW contest. I understand that I may withdraw consent for the specific identification of the Student at any time in the future, but withdrawn consent will have no effect on past use or publication of Student’s name, likeness, and location, or the inclusion of Student’s name, likeness, and location in any publication that is currently undergoing the printing process. Withdrawal of consent for the use of the Student’s name, likeness, image or identity does not have any impact on River of Words rights in the use of the individual works submitted on behalf of the Student. Consent for the use of the Student’s name and likeness can be withdrawn by contacting ROW directly at email@example.com.
I consent to use student's information
Agreement to Release Rights: I hereby release and discharge ROW from any and all claims and demands arising out of or in connection with the use of student’s name, likeness, location, the original artwork, writing, poem(s), photos, and video, including without limitations any and all claims for libel or invasion of privacy. This release shall be binding upon the student, myself, and our heirs, legal representatives, and assigns. I further release ROW from any responsibility for any injury incurred during the research or production of the original artwork, writing, poem(s), photos and video. This authorization and release shall also inure to the benefit of the successors, legal representatives, licensees, and assigns of ROW. In any of the winning categories, ROW maintains the exclusive right to declare no winner and withhold prizes if no poem or artwork of merit is found. ROW assumes no responsibility for lost or damaged poetry or artwork, and will not return submitted work. ROW may sell, assign, license, or otherwise transfer all rights granted to it hereunder. With respect to the above written consent for the use of the submitted works, the consent to the use of the Student’s personal information, and the agreement to hold harmless, I agree that I have read the foregoing and fully understand the contents thereof and on my own behalf, on behalf of the Student and the Student’s heirs and successors, and I agree to the terms stated therein.
I consent to use student's information
Should be Empty: