ENTRY FORM / TALENT RELEASE
INSTRUCTIONS: Print out this Entry Form ("print" icon, or File, Print from your top Menu Bar, then read, complete and submit with all required copies and attachments.
To enter the MS. COMPUTER EXPO 2001 CONTEST, you must be a female over 18 years old, and you must fill out and send this Entry Form/Release and PHOTOCOPIES OF TWO FORMS OF ID, ONE WITH PHOTO (i.e., divers license, passport, work or school ID card or photo ID issued by state). Second ID can be birth certificate, Social Security card, credit card, marriage certificate or immigration card. Send photocopies, not originals. All entries must be received on or before October 31, 2001 to be accepted.
Send two or more sharply focused color print photographs and headshots with resume. You may also submit a videotape - send videotapes in VHS format. All photos and videos become the unreturnable property of THE MS. COMPUTER EXPO 2001 CONTEST and Clark Consolidated Industries, Inc., it's sponsor, to which you hereby transfer, give and assign all rights in perpetuity to photos and videos submitted by you
Send photos, videos, this Entry Form/Model Release, your entry fee and PHOTOCOPIES of your i.d.s to
C.C.I.'s MS. COMPUTER EXPO 2001 CONTEST, 3380 S. Wynn Road, Suite A, Las Vegas, NV 89102.
NOTE: PRIZES WILL BE AWARDED TO ENTRANT ONLY. In consideration of entry into the MS. COMPUTER EXPO 2001 CONTEST, I hereby give, transfer and assign to Clark Consolidated Industries, Inc, its affiliates, successors and assigns, and those acting under it's permission or upon its authority, full worldwide rights and exclusive permission in perpetuity to copyright, and/or publish any and all photographs or videos of myself submitted to and/or obtained in connection with the contest, with or without my name, and to make any changes or any additions whatsoever to such photographs, videotapes, video footage, digital images, portraits or any of the above information, whether true or fictional. I understand that editorial matter, audio or voice over narration may accompany these videotapes and/or photos, and that my video footage may be accompanied by narration and/or commentary and can be distributed with other affiliated videos, and that my photographs or videos image can be published by, and in other Clark Consolidated Industries, Inc., affiliated videos, calendars, publications, World Wide Web sites, Photo CDs, magazines, and otherwise. I certify that I am of full legal age and am possessed of full legal capacity to execute the forgoing authorization. WARNING: ANYONE SIGNING THIS RELEASE FORM OTHER THAN THE MODEL WILL BE SUBJECT TO MONETARY DAMAGES AND/OR CRIMINAL PROSECUTION. I DECLARE UNDER PENALTY OF PERJURY THAT ALL OF THE INFORMATION I HAVE GIVEN HEREIN IS TRUE AND CORRECT.
(Your personal information supplied below will NOT be released without your written permission!)
Any alias, nicknames, stage or professional names:_____________________________
Name to be published:___________________________________________________
Date of birth: ___________________ Daytime Phone (include area code):______________________
Evening Phone (include area code):______________________ Your E-mail: _____________________________
Your Social Security number: _______________________ Your WWW Site URL: ________________________
Street Address:___________________________________________________ Apt. # ________
City:____________________________ State:________ Zip:___________________
Your Occupation: __________________________________
Your legal; signature:____________________________________________ Date: ____________________
Be sure to include your Entry Fee: Basic Entry Fee: $19 (see below for additional special classification entry)
: Includes your Entry Fee AND ALL of your choices of the additional contest classifications listed below. Because judging and points awarded are CUMULATIVE, your chances of winning can be increased by entering additional classifications!
Additional Contest Classification Entries: You may enter additional
Contest Classifications by submitting the appropriate Additional Entry
Classification Fees AND photographs, digital images and/or videotapes of
yourself for each special additional classification you enter. To enter
the additional classifications, please check your
[ ] Special Costume, $10 [ ] Swimsuit (Bikini, Thong or 1-piece), $10 [ ] Topless, $10 [ ] Nude, $10
SPECIAL ENTRY OFFER IS ONLY $29 (IF RECEIVED BEFORE HALLOWEEN, 10-31-01): Includes your Entry Fee AND ALL of your choices of the additional contest classifications (Special Costume, Swimsuit, Topless and Nude classifications - your choice of any or all), total only $29 inclusive if received at contest headquarters on or before October 31, 2001
Total Entry Fees Attached: $_____
SPECIAL NOTE:Because JUDGING IS CUMULATIVE, CONTESTANTS ENTERING ADDITIONAL CLASSIFICATIONS MAY RECEIVE HIGHER TOTAL CUMULATIVE POINTS AND THUS MAY HAVE A BETTER CHANCE OF WINNING than contestants not entering additional classifications.All entry forms and enclosures must be received by 10-31-01 to be considered.
1. Did you SIGN and DATE your Entry Form/Talent Release?
2. Did you attach photocopies of your 2 identifications?
3. Did you attach your Entry Fee? (money order or check only, do NOT send cash through the mail!)
4.Did you enclose photos, digital images and/or videotapes for the General Entry Class AND EACH ADDITIONAL CLASSIFICATION youre entering?
When complete, mail your Entry Form and all attachments to: C.C.I.'s MS. COMPUTER EXPO 2001 CONTEST, 3380 S. Wynn Road, Suite A, Las Vegas, NV 89102