Celebrate Bristol Artwork and Photo Contest Submission Form

"Celebrate Bristol" Art and Photo Contest Release Form
As part of the upcoming national 250th anniversary of the signing of the Declaration of Independence, and the City of Bristol’s local celebration through its Bristol America250 Committee, Wheeler Health and the City of Bristol invite all students in Bristol to celebrate this milestone and our amazing city by creating and sharing original artwork or photography featuring Bristol-focused places, events, people, or iconic symbols. Watercolor and acrylic paintings, color pencil, crayon, or charcoal drawings, as well as all forms of photography, including cell phone images, are welcome!

Winning artwork/photos will appear in a Wheeler-produced 2026 calendar, which will be distributed free while supplies last. Selected photos may also appear in our new community health center and in other Wheeler communications.

Participants are asked to refrain from submitting photos of people without express permission. A Wheeler media release form is available for this purpose.

If you have additional questions, or need a copy of the media release form, please contact Joanne Janes, Associate Director, Communications, Wheeler, 860.793.4403 or jjanes@wheelerclinic.org.
Submissions are due by May 30, 2025
Submitter's Contact Information

By "Submitter, we mean name of parent or guardian submitting entry for this student. Please provide specific details below.
Your Name

First NameLast Name
Your Relationship to Student
Name of Student

First Name Last Name
Student School
Student Grade
You Email
example@example.com
Your Phone Number

Area CodePhone Number
Your Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student Submission Details

	File Name	Description	Date	Location
1

Your submission should be no more than 4MB. If your photo or artwork is selected, we may contact you to request a higher-resolution image.
Upload Image 1

Browse Files

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Tell us about your artwork or photo!

In the space provided below, share a little bit more about this student's photo or artwork, e.g., why it's meaningful, related stories or facts, etc.
Please provide specifics:
Consent / Permission
Please review carefully and check all that apply.

I authorize and grant Wheeler Health permission to consider my child's/student's artwork or photo as part of its Celebrate Bristol Art and Photo Contest.If selected, I grant Wheeler Health permission to use this student's photos in a 2026 Wheeler-produced calendar, and potentially in other print, or digital materials, as well as social media platforms such as Facebook, X, LinkedIn, Instagram.I allow Wheeler Health to use my student's/child's photos for advertising and marketing purposes.Wheeler Health may use my child/student's name in advertising, marketing, and other materials as it relates to their photo or artwork submission.I understand that my child/student will not receive monetary compensation for this artwork or photo.If selected, I authorize Wheeler Health to feature my child's/student's artwork or photo at its new community health center at One Hope Street.I do not authorize Wheeler Health to resell my child's/student's artwork or photos.
Signature of Photographer/Applicant/Artist

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Date Signed

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Date
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"Celebrate Bristol" Art and Photo Contest Release Form

Submitter's Contact Information

Consent / Permission