a division of NATIVE HEALTH Children’s Art Contest “Why I Like My NH/NHW Provider” National Health Center Week NATIVE HEALTH is sponsoring a children’s art contest, during National Health Center Week, for children ages 7-12. One winner from NATIVE HEALTH and NHW Community Health Center will each receive a bike and helmet. To enter, draw a picture using any drawing medium (pencils, paints, markers, colored pencils, etc.) in the box below. Please use bright colors and the theme, “Why I Like My NH / NHW Provider.” Please be sure to complete the registration form. Deadline is Friday, August 01, 2014. a division of NATIVE HEALTH Children’s Art Contest “Why I Like My NH/NHW Provider” National Health Center Week How to Enter: Please complete registration form for each entry including an original title for the drawing. Children entering the contest must be current, registered patients of either NATIVE HEALTH or NHW Community Health Center. Complete this form and return with the drawing to NATIVE HEALTH, Attn. Diane Tsosie, 4041 North Central Avenue, Building C, Phoenix, AZ 85012. Prizes: One bicycle and helmet for per site. Official Rules and Regulations: In exchange for acceptance of a bicycle and helmet, each winner of the NATIVE HEALTH Children’s Art Contest agrees to assign all copyright, trademark and other intellectual property rights in their winning artwork to NATIVE HEALTH. By entering the contest, contestants and their parents, guardians and/or legal representatives warrant and represent that their artwork is their sole and original work product and release, discharge, indemnify and agree to hold harmless NATIVE HEALTH, it’s directors, officers, trustees, employees, agents, attorneys, representatives, successors and assigns from all other claims, demands, damages, causes of action, losses, liabilities, injuries or obligations, direct or indirect, known or unknown of any kind, nature or description whatever which the winner, winner’s parents, guardians, heirs, executors, successors or assigns may have or claim to have against NATIVE HEALTH, its directors, officers, trustees, employees, agents, attorneys, representatives, successors and assigns arising out of participation in or acceptance of any prize in connection with the contest, including any future use of the artwork. Deadline for submission is Friday, August 01, 2014. The contest is open to children ages 7-12. Contestants may enter as often as they wish. All entries, timely received, and not selected as winners may be resubmitted by NATIVE HEALTH for all successive drawings as noted above. By submitting an entry, each contestant and his /her parent /legal guardian agree they have read, understand and will comply with these official rules, and, or to the extent permitted by law, consent to the use of the Contestant’s name, likeness and/or biographical data for purposes of advertising and promotion by NATIVE HEALTH, without further consent, compensation or approval. Original artwork submitted with contest entry becomes the property of NATIVE HEALTH and cannot be returned. Winning artwork is not guaranteed to be used on NATIVE HEALTH merchandise or in connection with other NATIVE HEALTH goods or materials. Contest is NOT OPEN TO NATIVE HEALTH or NHW Community Health Center employees or their family members. NATIVE HEALTH Children’s Art Contest: “Why I Like My NATIVE HEALTH/NHW Community Health Center Provider”* Artist’s Name (Please print) AddressApt. # Artist’s Signature CityState Zip Original Title of Artwork Guardian’s Cell Phone Guardian’s Name (please print) Guardian’s email Guardian’s Signature Child must be a current, registered patient of NATIVE HEALTH/NHW Community Health Center. Initials: