Costume Contest Registration Form
Fill out the form carefully for registration
AGE GROUP ( check one )
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Please Select
0-12 MONTHS
13-24 MONTHS
25-48 MONTHS
49 MONTHS AND OLDER
Child's Name
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First Name
Last Name
Child's Age
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Costume name / description
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Parent / Gaurdian Name
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First Name
Last Name
Mobile Number
Format: (000) 000-0000.
Midway Tire and Auto may take photographs and/or videos of children participating in the Trunk or Treat Costume Contest. By signing below , I acknowledge and authorize Midway Tire and Auto to photograph or record my child and to use these images or recordings on the Business's official Fcebook page and other business-related promotional material
*
Please Select
YES , I GIVE PERMISSION for my child's photogrpagh and/or video to be used as described above
NO , I DO NOT GIVE PERMISSION for my child's photograph and/or vide to be used as descirbed above
if signed above as " NO , I DO NOT GIVE PERMISSION " WOULD YOU LIKE TO REVIEW ANY PHOTOS THAT MAY BE POSTED THAT MAY HAVE YOUR CHILDS IMAGE IN THEM BEFORE THEY ARE SUBMITTED
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YES
NO
If answered the above question as " YES " please provide a phone number
Please enter a valid phone number.
Format: (000) 000-0000.
I confirm that the information provided on this regristation form is accurate and that i am the child's parent or legal gaurdian, or am authorized to complete this regrisation. i understand that participating in the costume contest is voluntary and the contest winners will be determined according to the event's judging criteria
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First Name
Last Name
Submit
Should be Empty: