Please read the below parent permission agreement for child to be entered in the arts contest and select if you agree to the terms. If parent/guardian agrees to the term, HDI will follow-up with a phone call for confirmation.
1. I hereby give my permission for my child permission to participate in the Health Disparities Institute at UConn Health Visualizing Health Equity Arts Contest for Boys and Men of Color.
2. I understand my child will need to be present at a live gallery show in June 2019, if selected as a contest winner. I agree to accompany and supervise my child at this event, or to arrange for an adult chaperone to accompany and supervise my child at this event.
3. I agree that my child may participate in the contest described in the rules and is permitted to accept the prizes awarded, if selected as a contest winner.
4. Health Disparities Institute at UConn Health has my permission to use photographs, brief statement of artwork, or write a news story about my child’s artwork for the purpose of this arts contest only. I agree that the Health Disparities Institute and UConn Health may photograph and/or video record my child and his/her guardian or adult chaperone during the gallery show, and use or distribute any picture or video related to gallery show activities in which I, my child, or adult chaperone, is depicted. I also authorize use of these materials for publication in brochures, on websites, or other University of Connecticut promotional material. They may also be distributed to other gallery show participants, including but not limited to a gallery show group picture of all participants.
5. I certify and acknowledge that I have read, understood and agree to the terms set forth in the
Official Contest Rules and that I have read this Parental Permission Form prior to signing it; that I have the full authority to give my consent and release so that my minor child may participate in the Health Disparities Institute at UConn Health Visualizing Health Equity Arts Contest for Boys and Men of Color; and that I consent to provide the information concerning my minor child that is necessary to enter the contest and to receive the prizes to be awarded.
