Sea Glass Fiction Contest - Entry Form
Please check our guidelines and eligibility before submitting your entry. Thank you for your participation!
Student Name
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First Name
Last Name
Student Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email (Student email, if applicable)
example@example.com
Phone Number (Student number, if applicable)
Please enter a valid phone number.
Student is entering the following category:
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Grades 3-5
Grades 6-8
Grades 9-12
Current grade of student
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Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
GED Program
Other
School the student attends:
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Enter "Homeschool" if homeschooled.
Name of referring teacher (optional):
Name of Parent or Legal Guardian
*
First Name
Last Name
Phone Number of Parent or Guardian
*
Please enter a valid phone number.
Email of Parent or Guardian
*
example@example.com
File Upload
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Browse Files
Drag and drop files here
Choose a file
Accepted file formats are: .doc, .docx
Cancel
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What is the total word count of the entry?
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How did you hear about this contest?
*
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The following questions should be filled out by the parent/legal guardian:
I give my consent to allow my child to enter the contest.
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I agree
I confirm the entrant is a resident of the following county the majority of the year:
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Nassau County
Suffolk County
Other
I confirm that this entry is original, unpublished work written solely by the author.
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I agree
RIGHTS ASSOCIATED WITH CONTEST By submitting an entry form, entrants’ parent/legal guardian agree to: --- Grant The Whaling Museum & TBR News Media the right to edit, publish (in print and online), promote, and otherwise use their entry materials without permission, notice or compensation. No royalties will be paid at this or any time. --Warrant that their child’s/ward’s entry is their original work and does not infringe upon or violate rights of any third party. ---Release and hold The Whaling Museum & TBR News Media, and its employees, officers, directors, shareholders, agents, representatives, subsidiaries, parent companies, or other affiliated companies harmless from any and all damages, losses, claims and liabilities arising out of participation in the Contest or resulting from acceptance or claiming of any prize hereunder. --Abide by the Contest Rules. Submission of the Entry Form constitutes permission from the participant’s parent/legal guardian for The Whaling Museum & TBR News Media to use the participants’ name, likeness, biographical information, information and materials contained in the Entry Form, photographs, and any statements or remarks made about the Contest in advertising and promotion without further compensation or permission, except where prohibited by law.The Whaling Museum & TBR News Media reserve the right, in its sole discretion, to terminate, suspend or otherwise cancel the Contest at any time. The Whaling Museum & TBR News Media are not responsible for any expenses incurred in connection with participation in the Contest.
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I agree
Signature of Parent or Legal Guardian:
(Optional) Note for Judging Panel
Submit
Should be Empty: