City in a Park Photography & Poetry Contest Entry Form

Send us your greatest photo and/or poem inspired by Bellevue's park system. Selected work will be published in the 2010 Bellevue Parks & Open Space System Plan and other city exhibit spaces.

Parks are timeless treasures of our community. They preserve our history, both natural and human. They are places of play, relaxation, renewal and beauty. Their worth is immeasurable and benefits long-lasting.

Tell us about what inspires you when you visit a Bellevue Park.

Rules and Criteria:

• All work must be original and inspired by the treasures found in Bellevue's parks, trails and open spaces.
• Poems not to exceed 12 lines.
• One poem and/or photo per person. Poems and photos need not relate to one another.
• Park photos can be from any season. Photos must be submitted in Jpeg format with the highest resolution possible.
• You must live, work or play in Bellevue to participate.
• All ages welcome.
• Work must be suitable for the general public.
• Photo waivers are required when photo includes images of people. Waivers must be signed by each subject and submitted with entry.  photo waiver
• Hard-copy submittals must have completed application form and waiver included along with picture and/or poem. Attach a label on the back with the name of photographer or poet. application form 
• Entries will not be returned.
• Selection panel will include art experts and representatives of the City of Bellevue.

Submission Deadline: February 1, 2010

All fields marked with an asterisk (*) must be completed. You may submit poems directly in this form. For photos, you will receive instructions on how to submit them after you have submitted this form.

Name*
Address*
City*
State*
Zip Code*
Phone*	xxx-xxx-xxxx
E-mail*

PHOTO SUBMISSION

Title of Picture     

Description and Location of Picture:

Instructions on how to submit photographs will be provided after you submit this form.

POEM SUBMISSION

Title of Poem      

Text of Poem

Note:  If this text box does not allow you enough formatting options for the text of your poem, you will be provided with the opportunity to submit it in an alternate format after you submit information on this page.

TERMS AND CONDITIONS
In consideration of being permitted to enter Bellevue's City in a Park Photography and Poetry Contest, entrant declares and agrees as follows:

• I declare and affirm that (1) I am the person who created the work submitted;  (2) I own all intellectual property rights to and am legally authorized to submit this entry; (3) each person who may appear in a photo has given his/her written consent to be included in the photo, and for the photo to be displayed by the City of Bellevue or reproduced in publications without any fee or other form of compensation; and (4) the photo and/or poem entered has not been previously published.
• I agree to indemnify, defend and hold the City of Bellevue, its elected officials, officers and employees free and harmless from any and all claims, damages, costs and liabilities, arising out of any alleged infringement or violation of any intellectual property or other rights, as a result of my submission of any photo and/or poem to the City, or City’s duplication and/or use of the photo and/or poem for any purpose. This indemnity obligation applies to claims of infringement or violation alleged by me, the photo subject(s) and/or any and all other persons or entities.
• I grant the City of Bellevue a worldwide, non-exclusive, royalty-free, sub-licensable, and transferable license to use, reproduce, distribute, publish, prepare derivative works of, and display my entry in any and all media now known or hereafter developed (including, without limitation, print, broadcast, and Internet), for all legitimate business purposes including advertising and promotional activities, including but not limited to connection to this contest.
• By entering the contest, I agree that my photo and/or poem may be displayed or used by the City of Bellevue without any fee or other form of compensation and may be used in its entirety or in part, and/or may be revised or manipulated by the City.
• The City of Bellevue assumes no responsibility for lost or damaged entries or those that do not arrive by the deadline date.

I declare under penalty of perjury under the laws of the State of Washington that the forgoing is true and correct and that this declaration and application was signed as set forth below.

If the photograph and/or poem is the work of a minor under the age of 18, I affirm and declare as set forth above that I am the minor's parent or legal guardian and that I expressly consent to the photo and/or poem being entered in Bellevue's City in a Park Photography and Poetry Contest and displayed by the City of Bellevue.

By typing my name in the following box, I agree to these terms and conditions.*