Application Form - Fairfield`s Earth Day Celebration

Fairfield’s Earth Day Celebration
2015 Arts Contest
Thank you for your participation in Fairfield’s Earth Day Celebration
2015 Arts Contest!
This year’s theme is “When I look out my window I’d like to see…”
Entries may be in any of the categories listed below and must relate to
the environment, sustainability, and/or our effect on the world in
which we live.
All Entries Due by April 3, 2015
____ Age
____ Grade
Grade Division (check one)
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Primary (preschool-grade 2)
Intermediate (grades 3-5)
Middle School (grades 6-8)
High School (grades 9-12)
Special artist (all grades)
Art Category (check one)
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Dance Choreography
Film Production
Literature
Music Composition
Photography
Visual Arts
REQUIRED INFORMATION
Student First Name ___________________ Last Name ________________________________
School Student Attends _________________________________________________________
Parent/Guardian Name __________________________________________________________
Parent/Guardian Address _____ __________________________________________________
City _____________________________________ State_______ Zip ____________________
Parent/Guardian Email _________________________________ Phone __________________
I grant to the Fairfield’s Earth Day Celebration Committee (FEDC) an irrevocable, unlimited license to display, copy, sublicense,
publish, and create and sell derivative works from my work submitted for the Contest. The FEDC is not responsible for lost or
damaged works. Entries may not be returned. I affirm that this is my own original work. I acknowledge that it is my responsibility
to retrieve all work by May 30, 2015. I understand that the submission of my entry into the Contest constitutes acceptance of the
above conditions.
Have a question? Contact us at fairfieldearthday@gmail.com or visit us at http://www.FairfieldEarthDay.org.
Fairfield’s Earth Day Celebration
2015 Arts Contest
ARTS CATEGORY SPECIFIC QUESTIONS – Answer questions for the arts category relevant to your artwork
submission.
Title of Work (Required) __________________________________________________________________________
Artist Statement: in a separate document, explain how your work relates to the theme (Required; Min 10 words, Max
100 words)
Dance Choreography
1. What is the title of the dance music? _______________________________________________________________
2. Who is the performing artist or musical group? _______________________________________________________
3. Who is the composer?_________________________ Who wrote the lyrics? ________________________________
Film Production
1. If you used background music, what is the title? ______________________________________________________
2. Who is the performing artist or musical group?________________________________________________________
3. Who is the composer?_________________________ Who wrote the lyrics? _______________________________
4. List the names of the people who appeared in this film. _________________________________________________
_______________________________________________________________________________________________
Music Composition
1. Are there singers/instrumentalists? If so, how many and what are their names? ______________________________
_______________________________________________________________________________________________
2. Are there instruments? If so, what instruments? _______________________________________________________
_______________________________________________________________________________________________
Photography (please note: entry dimension may NOT exceed 11”x17”, including mat and must be no more than 3/8” thick)
1. Location of shot _______________________________________________ Date of shot ______________________
2. Dimensions of picture? L________ x W________ Dimensions with matting (no frames)? L________x W_________
Visual Art (please note: entry dimension may NOT exceed 24”x30”, including mat and must be no more than 3/8” thick)
1. Describe the medium or type of visual art you developed (e.g., crayons, collage, oil on canvas).
2. Dimensions of picture? L________ x W________ Dimensions with matting (no frames)? L________x W_________
Literature
1. Submit an electronic copy to the Fairfield’s Earth Day Committee at fairfieldearthday@gmail.com.
Fairfield Earth Day Celebration Release Waiver I hereby give the Town of Fairfield Connecticut, Fairfield’s Earth Day Celebration Committee permission to take my photograph, to record a video and/or to record my voice and to include said recording(s) or photos on its web site, newsletter and in press releases. I hereby release the Town of Fairfield from any and all claims and demands arising out of or in connection with the use of the photographs, videos and/or audio recordings, including any and all claims for defamation or invasion of privacy. This authorization and release shall also inure to the benefit of legal representatives, licensees and assigns of the Town of Fairfield as well as the person who took the photographs. I have read the foregoing and fully understand the contents hereof. Name (please print) _________________________________________________________________ Signature _____________________________________________________________________ Name of Conservator/Parent/Legal Guardian ________________________________________ (if applicable; please print)) Signature of Conservator/Parent/Legal Guardian _____________________________________ (if applicable) Witnessed by _________________________________________________________________ Date ___/ ____ / 2015_ Event: Fairfield Earth Day Celebration 2015____________________ Location: Fairfield Warde High School, 755 Melville Avenue, Fairfield, CT 06825____________ Photo Description: