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: License Plate Art Contest :

Thanks for participating!

*required field

CONTACT INFORMATION

If under 18 years of age, enter parent or guardian information.

First Name*
Middle Name
Last Name*
Street Address*
City*
State or Province*
Zip
Country, if other than US
Preferred Contact Number*
Preferred E-mail Address*
 
Artistic Media Used

ENTRANTS UNDER 18

First Name
Middle Name
Last Name
Age


UPLOAD ARTWORK

We accept .tiff and .jpeg formats, see guidelines for sizing.

Attach Document


CONSENT, WAIVER OF LIABILITY, INDEMNITY & RELEASE

I irrevocably grant to the Glen Helen Ecology Institute of Antioch College [name of submitter] employees, officers, agents and assigns (hereinafter referred to as “RELEASED PARTIES”), the exclusive, royalty-free, perpetual and worldwide right and permission to use, reproduce, adapt, and display the original artwork that I have submitted to the Glen Helen Ecology Institute of Antioch College (“artwork”), on or in connection with license plates and the non-exclusive, royalty-free, perpetual, worldwide right to use, reproduce, adapt, and display the artwork in any and all media, for any purpose whatsoever. In connection with the foregoing license, I agree not to use, reproduce, adapt, or display the artwork, or allow others to do so, in a manner that tends to subject the Glen Helen Ecology Institute license plate to ridicule, disparagement, mockery, satire, or that could tarnish the image of the Glen Helen Ecology Institute or Antioch College.

I understand and agree that the Glen Helen Ecology Institute of Antioch College can file applications to register trademark(s) or service mark(s) that incorporate the artwork in connection with license plates and any organizational programs. I hereby release and discharge the Glen Helen Ecology Institute and Antioch College from any and all claims and demands arising out of or in connection with the use of the original artwork, including without limitations any and all claims for libel or invasion of privacy. The Glen Helen Ecology Institute maintains the exclusive right to declare no winner if no design that meets the Institute’s needs is found. The Glen Helen Ecology Institute and Antioch College assumes no responsibility for lost or damaged artwork. The Glen Helen Ecology Institute of may sell, assign, license, or otherwise transfer all rights granted to it hereunder. This release shall be binding upon me and my heirs, legal representatives, and assigns. I further release the Glen Helen Ecology Institute and Antioch College from any responsibility for injury incurred during the research or production of the original artwork.

If the submittal is a photograph(s), I warrant that I photographed it from public, personally owned, or Glen Helen nature Preserve property. I declare and avow that the artwork I am submitting to the Glen Helen Ecology Institute’s License Plate Design Contest is(are) my own original work in all respects. I am the sole and exclusive owner of the artwork; it(they) is(are) free, clear, and unencumbered. No part of it(them) is taken from or based on any other work; no part infringes the copyright or any other right of any person; and the reproduction, publication, exhibition, or any other use by the RELEASED PARTIES of the Photograph(s) in any form whatever will not in any way, directly or indirectly, infringe on the rights of any person.

I waive any right to inspect or approve any finished product, advertising or other copy that may be used in connection therewith or the use to which it may be applied.

I understand and agree that the artwork may be used in whole or in part, at any time, in composite or distorted form, in color or otherwise and may be published through any medium including, but not limited to, printed medium, video and/or on the internet. This consent authorizes both any initial and any subsequent disclosure or publication of the artwork at any time.

I waive any right to inspect or approve any finished product, advertising or other copy that may be used in connection therewith or the use to which it may be applied.

I understand that if the artwork is selected, in the process of converting it to a license plate, it may be necessary for the artwork to be altered to some extent. I hereby grant and assign the Glen Helen Ecology Institute the right and permission to conduct or have conducted such alterations as the Glen Helen Ecology Institute deems necessary. I release and discharge all RELEASED PARTIES from any liability by virtue of any blurring, distortion, alteration, optical illusion or use in composite form, loss or damage, whether intentional or otherwise, that may occur in the processing or preparation of the finished product.

I agree to indemnify all RELEASED PARTIES from and against any and all loss, damage, costs, charges, legal fees, recoveries, judgments, amounts paid in settlement, penalties, and expenses that may be obtained against, imposed on, or suffered by the RELEASED PARTIES by reason of (1) any violation or infringement of any proprietary right or copyright; or (2) any libelous or unlawful matter contained in the artwork. I also agree to indemnify all RELEASED PARTIES for any such amounts arising from my breach of any covenant, representation, or warranty of this agreement.

I declare that I am eighteen (18) years old or older and am legally competent to execute this release or that I have acquired the written consent of my parent or guardian.

I understand that the terms herein are contractual and not a mere recital, that this instrument is legally binding, and that I have voluntarily signed this document.

I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS CONSENT, WAIVER OF LIABILITY AND RELEASE BY READING IT BEFORE SIGNING IT ON BEHALF OF MYSELF AND MY HEIRS.

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