2016 Regional High School Art Show Registration Form PLEASE PRINT CLEARLY

ALL ARTWORK SUBMITTED MUST BE FOR SALE

Student Name:

COMPLETE Mailing Address:

Phone: Email:

Grade: Age:

*Parent/Guardian (print): Phone: *This info is needed even if student is 18

School: Principal:

School Address: Superintendent:

District: County:

Art Instructor First & Last name:

Art Instructor Phone: Email:

Title of Entry:

Medium:

Description of Piece:

Special Ed Entry: yes or no (SpEd will not be identified) Entry 3-D: yes or no

Inspiration (1 or 2 sentences ONLY):

**Students and Parents: Please read before signing**

1. All artwork submitted must be for sale. While it is not sold to the general public, the Puget Sound ESD or OSPI could purchase it for their permanent collections. If you do not wish to part with your artwork, please submit another piece. 2. All 2-D artwork must have a weight-appropriate line (wire, fishing line, etc.) securely attached across the back for hanging. We will implement a 5-point penalty for any 2-D artwork received that does not have a secure line attached. This would negatively impact whether your piece will advance to the state competition and/or receive an award. 3. Student artwork will remain at PSESD from January 11 – March 16. You will not be allowed to pick up your entry until after the reception on March 16. If you need your artwork for another show, do not enter it. Regional Award winners’ entries will advance to the State Art Show in Olympia and will be returned to PSESD on/about May 31, 2016. 4. Any artwork remaining at PSESD after June 30, 2016, will become the permanent property of PSESD. 5. If possible, submit a high-resolution digital photo (at least 180 dpi) of your artwork to [email protected]. 6. PSESD & OSPI would like to showcase all entries in the Regional and State High School Art Shows in various multi-media formats including, but not limited to, the PSESD (www.psesd.org) and OSPI websites (www.k12.wa.us). In doing so, this information will be open to public view. Entering your artwork and signing this form gives PSESD and OSPI permission to showcase your artwork; this could include photos of students with their artwork and/or awards, students’ names, and school names.

ORIGINALITY CERTIFICATION: I hereby certify that this is my original work and that it is not copied, replicated, or manipulated from a published photograph, magazine, book illustration, or computer manipulation from published work.

RELEASE AND CONSENT: We, the undersigned, grant our consent for public display of the art entry and release Puget Sound ESD and OSPI (and their respective staff) from all liability for damage, loss or misappropriation. Furthermore, we understand that should the entry become one of the Puget Sound ESD Purchased Award winners or State winners, it will then remain in the permanent art collections of Puget Sound ESD or OSPI, respectively.

Student Signature Parent Signature Date