Healthy Waldo County
Are you the "U" missing in Comm__nity
Public Service Announcement Contest
Please complete the following information
(I permit my son/daughter to participate in Healthy Waldo County's Public Service Announcement
Contest and I understand that his/her entry may be used to promote a Social Norms Campaign to
help in the effort to prevent underage drinking.)
Deadline for the finished PSAs will be May 31, 2009.
Address final PSAs to: PSA Contest
All entries will agree to release, indemnify and hold harmless Healthy Waldo County, and any other organizations related to the contest from any claims, injuries, damages, or losses to the person or property and/or liabilities of any nature that in any way arise from participation in this contest or acceptance or use of a prize or parts thereof. All submissions, and any and all rights in submissions, become the property of Healthy Waldo County. Entries will not be returned.
CONTEST
Entry Form
Acceptable Formats: Flyer, Poem, Poster or DVD can be sent electronically through e-mail or contact Nancy Tkachuk at 338-2200 ext 105
Name
Address
E-mail
Telephone Number
Entry Form
Parent Name
Parent Signature
Date
Title of entry
Format
Theme
Names of those contributing to PSA
Questions
Theme
Other
Entry Form
You can and do make a difference!
Use your talent to change our community.
Age
Grade Level
School District
Other
