Please fill up this form and return with your artwork(s) to the address indicated below by November 30th 2017
8362 Paluxy Dr., Tyler TX 75703
Please print neatly as all information must be legible
Artist’s name____________________________________________________ Phone___________________________________
Total Entries___________ ($8.00 / entry) Total amount Enclosed______________________________________
Entry # Title of Entry Media Entry size School Grade/Age
Parent’s or legal guardian’s Signature: ______________________Print your name: _____________________________ Date:_______________
Signing this form, you confirm your contribution to the project Russians For Americans. You give your permit to Valeria ArtLab (USA) and The Children Center “Strekoza” (Russian Federation) to use the artwork(s) of your child, and understand that the image of the artwork can be printed, awarded, or sold for the project purposes. However, the author’s rights for the image of the artwork will still belong to its author, i.e. your child, and the organizations will keep the name of Artist connected with the artwork.