Texas Department of Agriculture Student Art Contest Submission Packet

Transcripción

1 Texas Department of Agriculture Student Art Contest Submission Packet Please fill out the following forms. All required* forms must be filled out completely. Entry Form*..Page 1 This form is required to enter the Art Contest and provides information about the participant. Artwork and Photo Release*.Page 2 This form is required to enter the Art Contest and allows the Texas Department of Agriculture to use your artwork to inspire the posters for National School Lunch Week or School Breakfast Week if you are chosen as a winner. Artwork and Photo Release (Spanish).Page 3 This form is required to enter the Art Contest and allows the Texas Department of Agriculture to use your artwork to inspire the posters for National School Lunch Week or School Breakfast Week if you are chosen as a winner. Photo Release Child.....Page 4 The photo release is needed if you choose to send in a photo of the student with his or her artwork to be featured in publications if he/she is selected as a winner or runner up. Photo Release Adult..Page 5 The photo release for an adult is needed if a parent, teacher, or principal is in the photo of the student with his/her artwork. Student Artist Questionnaire.....Page 6 We encourage all students to fill out the questionnaire so we can share something about them in our publications if they are selected as a winner or runner up. TEXAS DEPARTMENT OF AGRICULTURE COMMISSIONER SID MILLER Food and Nutrition Division Art Contest This product was funded by USDA. This institution is an equal opportunity provider. Updated 11/2018

2 Texas Department of Agriculture Departamento de Agricultura de Texas Texas Student Art Contest Concurso de Arte Estudiantil de Texas Entry Form Formulario de entrada 1 ARTWORK SUBMISSION(S) PRESENTACIÓN DE LA OBRA DE ARTE National School Lunch Week Theme (NSLW)/Tema de la Semana Nacional de Almuerzos Escolares: School Breakfast Week Theme (SBW)/Tema de la semana de desayuno escolar: Submitting artwork for both campaigns Envío de ilustraciones para ambas campañas 2 STUDENT INFORMATION INFORMACIÓN DEL ESTUDIANTE First Name Nombre de pila M. I. Last Name Apellido Sr. Jr. School Name Nombre de escuela Grade Level Nivel de grado 3 STUDENT CONTACT INFORMATION INFORMACIÓN DE CONTACTO DEL ESTUDIANTE Address Dirección City ciudad State estado Zip Code código postal Parent/Guardian Name Nombre del Padre / Guardián Address Dirección de correo electrónico Phone phoen ( ) - 4 SCHOOL CONTACT INFORMATION INFORMACION DE CONTACTO DE LA ESCUELA Sponsoring Teacher s Name Nombre del Maestro Patrocinador Address Dirección de correo electrónico School Address Dirección de Escuela City ciudad State estado Zip Code código postal School Principal s Name Nombre del director de la escuela Address Dirección de correo electrónico Texas Student Art Contest Entry Form Formulario de Inscripción para el Concurso de Estudiantes de Texas Texas Department of Agriculture Food and Nutrition Departamento de Agricultura de Texas - Alimentos y Nutrición This product is funded by USDA. This institution is an equal opportunity provider. Este producto es financiado por USDA. Esta institución es un proveedor de igualdad de oportunidades. 1

3 TEXAS DEPARTMENT OF AGRICULTURE Standard Artwork & Photo Release (English) (Por favor vea abajo para la traducción al español.) I hereby confer on the Texas Department of Agriculture (TDA) the absolute and irrevocable right and permission, with respect to all original artwork created and submitted by me, including paintings and drawings in any medium, including but not limited to: watercolor, oil, acrylic, casein, gouache, pastel, charcoal, pencil, ink, graphite or other medium ( artwork ) and to any photographs, video, and other media taken of me: a) To copyright the same in TDA name or any other name that it may select; b) To use, re-use, publish and re-publish the same in whole or in part, separately or in conjunction with other photographs, in any medium now or hereafter known, and for any purpose whatsoever, including (but not by way of limitation) illustration, promotion, advertising and trade, and; c) Whenever possible, TDA will include or attribute my name(s). These materials may be published by TDA and include, but are not limited to: network and local news programs, websites, distributed printed and original materials, in publications and on social media. I hereby release and discharge TDA from any and all claims and demands ensuing from or in connection with the use of the artwork or photographs, including any and all claims for libel, invasion of privacy and for copyright infringement. I agree to participation without any financial compensation and release TDA and/or its employees, agents, representatives and the state of Texas authorized by TDA from any future claims, as well as from any liability arising from the use of said artwork, photograph(s), interview(s), or video(s) or portions thereof used for public viewing. This authorization and release shall inure to the benefit of the legal representatives, licensees and assigns of the artists and photographers as well as the person(s) for whom the artwork was created or for whom the photographs were taken. I have read the foregoing and fully understand the contents hereof. I represent that I am the person named below, or the person s authorized parent or guardian. Signature Printed Name (or Name of Parent/Guardian) Company Name (If Applicable) Printed Name of Minor (If Applicable) Address, City, State, Zip Code Phone Number Address Date 2

4 DEPARTAMENTO DE AGRICULTURA DE TEXAS Obra estándar y liberación de fotos (Español) Por la presente doy al Departamento de Agricultura de Texas (TDA) el derecho absoluto e irrevocable y permiso, con respecto a todas las ilustraciones originales creadas y presentadas por mí, incluyendo pinturas y dibujos en cualquier medio, incluyendo pero no limitado a: acuarela, aceite, acrílico, caseína, gouache, pastel, carbón, lápiz, tinta, grafito u otro medio ("obra de arte") ya cualquier fotografía, video y otros medios de comunicación tomados de mí: a) Para autorizar el mismo en el nombre de TDA o cualquier otro nombre que pueda seleccionar; b) Utilizar, reutilizar, publicar y volver a publicar el mismo en su totalidad o en parte, por separado o en conjunción con otras fotografías, en cualquier medio conocido en el presente o en el futuro, y para cualquier propósito, incluyendo (pero no por vía) de limitación) ilustración, promoción, publicidad y comercio, y; c) Siempre que sea posible, TDA incluirá o atribuirá mi nombre (s). Estos materiales pueden ser publicados por TDA e incluyen, pero no se limitan a: programas de noticias en red y locales, sitios web, materiales impresos y originales distribuidos, publicaciones y medios sociales. Por este medio libero y descargo a TDA de todas y cada una de las reclamaciones y demandas derivadas o relacionadas con el uso de las ilustraciones o fotografías, incluyendo todas y cada una de las reclamaciones por difamación, invasión de privacidad y violación de derechos de autor. Estoy de acuerdo en participar sin ninguna compensación financiera y liberar a TDA y / o sus empleados, agentes, representantes y el estado de Texas autorizado por TDA de cualquier reclamación futura, así como de cualquier responsabilidad derivada del uso de dicha obra de arte, ), entrevista (s), o video (s) o partes de los mismos utilizados para la audiencia pública. Esta autorización y liberación se hará en beneficio de los representantes legales, licenciatarios y cesionarios de los artistas y fotógrafos, así como de la persona o personas para las que se creó la obra o para quienes se tomaron las fotografías. He leído lo anterior y entiendo completamente el contenido de este documento. Yo represento que soy la persona nombrada abajo, o el padre o guardián autorizado de la persona. Firma Nombre impreso (o nombre del padre / tutor) Nombre de la empresa (si corresponde) Nombre impreso del menor (si corresponde) Dirección, Ciudad, Estado, Código Postal Número de teléfono Dirección de correo electrónico Fecha 3

5 PHOTOGRAPH RELEASE I, the undersigned, hereby grant permission to the Texas Department of Agriculture and its employees, officers, agents, representatives and assigns (TDA) to use photographs taken of me and/or my child(ren). I grant permission together with the right to use, publish, copyright and reproduce in whole or in part any such photographic images in agency publications such as newsletters and magazines, and to use such photographs in electronic versions on agency websites or other electronic form or media for any legitimate purpose of TDA. I hereby waive any right to inspect or approve the finished photographs or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the photograph. I hereby voluntarily release and hold harmless TDA from any and all liability arising out of or in any way related to the use of such photographic images and comments, including but not limited to any liability arising by virtue of any blurring, distortion, alteration, illusion, editing, or use in composite form, whether intentional or otherwise, that may occur in the making or processing of the finished product. I am 18 years of age or older and I am competent to contract in my own name. I am the parent or guardian of the child photographed and I am competent to contract for them. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. Child s Name (please print) Date Parent or Guardian s Name (please print) Signature of Parent or Guardian 4

6 PHOTOGRAPH RELEASE I grant permission to the Texas Department of Agriculture to use photographs taken of me for use in agency publications such as newsletters and magazines, and to use such photographs in electronic versions on agency websites or other electronic form or media. I hereby waive any right to inspect or approve the finished photographs or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the photograph. I hereby agree to release, defend, and hold harmless the Texas Department of Agriculture and its agents or employees from and against any claims, damages or liability arising from or related to the use of the photographs. I am 18 years of age or older and I am competent to contract in my own name. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. Date Name (please print) Signature Name (please print) Signature Name (Please Print) Signature Name (please print) Signature 5

7 Texas Department of Agriculture Student Artist Questionnaire Please answer the following questions for our student artist profile. If your artwork is chosen to win, the following information may be included in a press release or in the Texas Department of Agriculture Newsletter to provide information about the winning student artist! Name and Grade level: What inspired you to create your artwork? What s your favorite class and what do you like about it? If you are involved in extracurricular activities what are they? What do you want to be when you grow up? What do you like to do for fun? Do you have any pets? Have you had any experience with agriculture, and if so what was it? What food do you like eating in the school cafeteria? Include a photo of yourself with your artwork! 6