Entry form
                                       
The photographer (PLEASE USE BLOCK CAPITALS ON THE FORM)

Name: .................................................................

Address: .................................................................

 .................................................................

.................................................................

 .................................................................
 

Telephone Number: ..............................................

Email: ..................................................................

Do you want to receive further communication from the Friends of Dereham AC by Email  YES / NO (delete as applicable)

Photographers under 16 - Age: ...........................

Signature of parent or guardian: ....................................................

The Cat(s)

Name(s), Ages and sex:..........................................................................................................

Cat`s owner if different from photographer:.................................................................

Name of person in photo (if applicable):.................................................................

If the cat is not your own

Owner’s name:.................................................................

Owner’s permission granted   YES / NO  (delete as applicable)

If a person appears in your photograph
 
Name of person in photo:.................................................................

Consent to publish obtained from person in photo YES / NO  (delete as applicable)

Age of person in photo (if under 16):.................................................................

Photographs showing children under the age of 16 must be accompanied by parental consent for use of the photograph.
I am the legal parent/guardian and I hereby grant permission for Dereham Adoption Centre to use this/these photographs for this competition also website & newsletter.

Signed:..........................................................................

Declarations

I confirm that I have taken this/these photograph(s) myself and I agree to co-operate to the best of my ability with any publicity undertaken by The Friends of Dereham and also Dereham Adoption Centre for this competition

I permit the Friends of Dereham & the Adoption Centre to reproduce, in any material form, any photograph entered into this competition by me without the need to obtain my permission to do so as the copyright owner, in order to further the work of or raise funds for the aforementioned.

Signed:............................................         Date:...............................................

Data Protection

Would you like further offers from other carefully selected companies to be made to you. YES / NO  (delete as applicable)

Do you wish to receive communications (by phone, post or fax) from Cats Protection only, YES / NO  (delete as applicable)

Registered Charity 203644                    

Please print off and send to us

Or email us (follow link)   
 
Entries by email are accepted but will only be entered once the entry has fee has been received.