Missouri Lottery
"Show Me Your Pet"
2014 Calendar Photo Contest Entry Form

Original photographs or photo CDs (one CD per entry) and contest entry forms must be mailed to:

“Show Me Your Pet” Calendar Photo Contest
Missouri Lottery
P.O. Box 1603
Jefferson City, MO  65102-1603

(Digital photos must include a printed copy of the photo and the original picture on a CD.  See official rules for details. Sorry, photos and CDs will not be returned.)

Deadline for receipt of entry: 5 p.m. on Friday, Sept. 20, 2013

(Please print and complete the form to send with your photo entry via postal mail or drop off at a Lottery office.)

Photographer's Name:______________________________________________________________

Mailing Address:___________________________________________________________________

City, State, Zip:_____________________________________________________________________

Daytime Phone (8 a.m. - 5 p.m.): (        )______________  Alternate Phone: (        )________________


What's your pet's name and breed?: ________________________________________________________________________________


Description of photo: (In 100 words or less, explain what the photo illustrates.) ________________________________________________________________________________



Month/Year photo was taken:__________________________________________________________

By submitting this form, I hereby release the Missouri Lottery, its employees and agents, successor and assigns, from any and all claims which I may have arising out of any use of my photograph, name and likeness. I confirm that I am the owner of all rights, including copyright of the attached photo, and that I have read and agreed to the rules of the contest.

Date:____________________________ Signature:________________________________________

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