City of Pomona Cultural Arts Commission Annual Chalk Art Festival Individual Participation Form
***Registration is now closed!***

We're excited to have you all at this event to celebrate our wonderful community. This year's festival will be held on Saturday, November 10, 2018 from 730am-245pm (if it rains, Saturday, November 17, 2018). The festival is free and open to the public!

Before attending the event, please carefully read the Information and Guidelines packet about important dates, themes, structure format and prizes, which can be found here:

See you there!!

Individual Participant Information
Please note that every individual participant must complete this form to be eligible for participation! You will then compete in teams of 2-4 or as an individual professional.
What's your first name? *
Your answer
What's your last name? *
Your answer
What's your Zip code? *
Your answer
What's the best number to reach you at? *
Your answer
What's your e-mail?
Your answer
Which category will you be participating in? If you're unsure, please read through the Information packet at the link above! *
Which school or organization do you belong to?
Your answer
If you're participating from a school, what is your teacher's name?
Your answer
What's your preferred t-shirt size? *
Please carefully read through the City of Pomona Waiver/Hold Harmless Statement and PUSD Statement:
City of Pomona Waiver /Hold Harmless Statement:

I understand that all art work completed at the festival becomes property of the City of Pomona and may be used or reproduced at the Commission’s discretion. I further understand the regulations as set forth for this event: The image(s) will contain no offensive material such as nudity (of any kind), depictions of violence, derogatory signs, language or epitaphs that would encourage discrimination against any religion, race, nationality, disability, or sexual orientation; or any drug, gang, or sexually related material. Any violation of this agreement will subject participant(s) to disqualification and exclusion from the competition/raffle.

The festival is a competition for which prizes will be awarded. Chalk will be provided to the participants free of charge. Please, no spray fixatives or sealants. I hereby declare full knowledge of all inherent risks and hazards associated and incidental to the Pomona Annual Chalkart Festival.

I do hereby release, absolve, indemnify and hold harmless the City of Pomona and its employees from any and all claims of damages for personal injury or other damages that may be sustained as a result of participation in any of the programs/event activities. I further waive any and all such claims against any and all sponsors, volunteers, and staff of supervisors appointed by the City of Pomona, as well as any person(s) providing transportation, if applicable, to and from the event/program activities.

PUSD Statement:

I further understand that: This event is not sponsored by the Pomona Unified School District (the “School District”). Participation is pursuant to an agreement between the student and the City of Pomona and in no way does the School District assume any sponsorship or supervision or responsibility for the activities set forth in this statement.

By checking the box below, you agree to the regulations set forth by the City of Pomona. *
Please enter your name below acknowledging that you've read through the Waiver/Hold harmless statement. If you're a minor, please enter your parent or guardian's name. *
If applicant is a minor, this form must be signed by a parent or guardian. (Ex: Jane Doe, parent).
Your answer
Thanks! Here is contact information for further questions. We look forward to your participation!
The closing date for submitting the Participation Form is Monday, November 05, 2018. If you have any questions, please contact Pomona Planning Division Program Specialist Nancy Garcia at (909) 620-2090. Para información en Español llame (909) 620-2090
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service