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CITRONELLE JUNIOR WOMAN'S CLUB
2005 Beautiful
Baby Contest - benefits March of Dimes
ENTRY/CONSENT & RELEASE
FORM
Baby's Name: _________________________________________________
Guardian's Name:________________________________________________
Address: ____________________________________ City: ____________________
State: _____ Zip Code: ___________ Phone #’s: _____________________________
Baby's Date of Birth (newborn - 36 months): _____________Male or Female______________
I hereby give
permission for my child's photo & name to be used in all aspects of
CJWC's "Beautiful Baby Contest". I will provide a NON-COPYRIGHTED photo if
my child wins. I also agree not to call the Call News
or the Marketplace for results of the contest.
Signature:
________________________________________________________
You may mail this form, along with $5 and a 5x7 (or smaller) photo with child's name & telephone # on the back, to:
CJWC
P.O. Box 172
Citronelle, AL 36522
If you would like your photo returned, include a SASE large enough, and with appropriate postage for the size. You may also bring these items to Call News or Southern Blessings during normal business hours.