2021 Annual Breastfeeding Photo Contest Authorization Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Your Name *

Address *

Phone number *

E-mail *

I have permission to submit the photo to this contest. In the case of an image taken by a professional, I agree to submit a completed photo release form from the photographer to the contest organizer. *

I own the rights to the photo

I will submit a release form from the photographer

If one or more individuals (other than my child) appears in the photo, I agree to submit a completed photo release form from the individual(s) in the photo to the contest organizer.

I am alone with my child in the photo

I will submit a release form from the other individual(s) in the photo

Clear selection

CONTEST RULES

The contest will take place between August 30rd and September 21st, 5 pm.
This contest is open to residents of the Magdalen islands. Photos from residents of other regions will be posted, but are not eligible in the contest. Please note that it is the mother (parent) breastfeeding in the photo who wins the prize, not the photographer.

It is not necessary that the photo was taken in 2022.

To participate, all you need to do is download the registration form on our website www.seinpathique.com, it can also be sent by email if you send a request to entraide@seinpathique.com or by Messenger.

The completed registration form along with a digital version of the photo must be sent to: entraide@seinpathique.com

We are looking for all types of photos, amateur or professional, representing a mother (parent) breastfeeding their child in different contexts, circumstances and environments. The selection committee reserves the right to exclude certain photos if they do not correspond to the criteria or to the organization’s mission. The photo can be in colour or black and white.

The photo will be exposed in different locations, including social media, during World Breastfeeding Week 2021, which takes place at the end of September, and visitors can choose the photo coup de coeur by voting. The selection committee will calculate the number of votes received for each photo. The photo with the most votes will be declared « Photo coup de cœur » and the designated participant will win a prize. A participation prize will also be randomly drawn among the participating photographs. All prizes must be accepted as is: they cannot be exchanged and have no cash value.

To be eligible for a prize, participants must complete and sign the registration form as well as ensure that all persons appearing in the photo also sign the document.

Any photo not accompanied by the registration form will be refused.

I declare that I have read the contest rules and regulations and I accept the terms and conditions. I also accept that by entering the contest, I agree that photos submitted can be published by Sein-Pathique for contest purposes.

Required

I authorize Entraide Sein-Pathique to use the photo submitted for promotional purposes within the organization (prenatal classes, workshops, and other activities). *

Yes

I authorize Entraide Sein-Pathique to use the photo submitted for promotional purposes on social media and the internet (website, Facebook, Instagram). *

Yes

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Entraide Sein-Pathique. Report Abuse

Forms