PLEASE READ CAREFULLY

In order to claim the Prize described below, you must first correctly answer, without mechanical aid, this mathematical skill-testing question: (required)
(10 X 7) ÷ 5 + 136 =

I, the undersigned, am the custodial parent or legal guardian of a child who has participated in
Natasha's Wood Foundation 2018-2022 Youth Art Campaign (the “Campaign”), and whose Artwork has been finally selected as one of the 40 pieces of Artwork that will appear in special edition early reader picture books authored by Fay Maddison as part of Natasha’s Wood Foundation’s 2018-2022 Youth Art Campaign (as described in the Campaign’s Official Rules).

In consideration of my child being declared a winner of the Natasha’s Wood Foundation Youth Art Campaign and for all other good and valuable consideration, the sufficiency of which are hereby acknowledged, I hereby:

1. agree to accept, on behalf of my child, the Prize, as awarded, which prize consists of the appearance of my child’s Artwork as submitted in accordance with the Campaign’s Official Rules, in special edition early ready picture books authored by Fay Maddison. The estimated retail value of each early ready picture book is $12.00;
2. understand that the present form must be duly signed by me and returned to Natasha’s Wood Foundation Youth Art Campaign by email at enquiries@natashaswoodfoundation.org, failing which the attribution of the Prize may be forfeited;
3. authorize Natasha’s Wood Foundation and any of its advertising and promotional agencies to use my child’s name, city and/or, province/territory of residence, the photographs, likeness or images of my child, my child’s voice, and/or any verbal or written statements he or she made or may make about the Campaign for advertising, promotional or other purposes, at any time, in any manner and without restriction of any kind, in any media, on any support and in any country of the world, the whole without any compensation;
4. confirm that the Prize is non-transferable, non-exchangeable and non-reimbursable and its receipt by me, on behalf of my child, shall fully discharge and release the Natasha’s Wood Foundation and its directors, officers, employees, representatives, agents as well as their respective advertising and promotional agencies (collectively, the “Releasees”) from any and all liability arising in connection with his/her participation in the Campaign and acceptance of the Prize, including, without limitation, any financial, legal or moral responsibility or loss or personal injury, including death, or damage to or loss of property suffered or incurred or arising from participating in the Campaign or accepting the Prize, whether suffered by myself and/or my child, and notwithstanding that such injuries or losses may have been caused solely or partly by any act, omission, negligence or gross negligence of any or all of the Releasees;
5. confirm that the foregoing shall inure to the benefit of and be binding upon my successors, assigns, heirs, administrators and executors and those of my child, as the case may be;
6. declare that:
1. both my child and I have complied with, and will comply with, Official Rules;
2. my child is a resident of Canada;
3. I am the custodial parent or legal guardian of the Campaign Participant who is being awarded a Prize and understand and agree that by signing below, I bind him or her to the terms of this Prize Declaration and Release of Liability Form; and
4. this declaration is, to the best of my knowledge and belief, a true and accurate statement of the facts contained herein;

This Prize Declaration and Release of Liability Form does not extinguish any or all other releases and waivers that were signed in relation to the Contest.

I accept the above terms and conditions. (required)
Name of minor: (required)

Name of custodial parent or legal guardian: (required)

Signature of custodial parent or legal guardian: (required)

Your phone number: (required)

Your Email (required)

Date: (required)


Authorised acceptance by Natasha's Wood Foundation representative