Energy and the Environment Art Contest

Entry Form

Please print the form and then fill in the required information.

I, ______________________________ (your full name), am the parent or legal guardian and hereby certify that this entry was completely drawn by the student named above. I agree that this artwork becomes the exclusive property of the Department of Natural Resources Canada (NRCan), which reserves all rights. I give NRCan permission to use, reproduce, publish and republish, individually or in conjunction with other original work my child’s winning drawing in educational and promotional resources associated with NRCan’s Office of Energy Efficiency and the Kids’ Club.

I understand that by entering this contest, any and all copyrights for the artwork submitted are assigned to NRCan and give consent to the public disclosure of my child’s full name, grade and/or age, school and province of residence. THIS ENTRY WILL NOT BE RETURNED.

Signature of parent/legal guardian ___________________________________

Signature of student _____________________________________________

Date ___________________________________________________________

The personal information collected under this program is described in Personal Information Bank PSU 914, will be retained for 8 years after program and will be processed by the Natural Resources Canada / Energy Sector / Office of Energy Efficiency / Outreach and Information Division.