2024 Imagine That! Middle School Art Contest

Imagine That!

Middle School Art Contest 2024
Participant Name*

First NameLast Name
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Is the parent/guardian a Consumer-member of Flint Energies?*

YesNo
Participant's School*
Grade*

678
Title of Entry
Statement of Consent:

I give permission for my student to participate in the Imagine That! Art Contest sponsored by Flint Energies, and consent for his/her name and entry to be publicized in print or online media should they be selected as a winner.
Consent to participate*

I give my permissionI do NOT give permission
Signature*

Clear
Should be Empty: