The Its Always Something Teen Essay Contest

RELEASE FORM

The Gildas Club Desert Cities Its Always Something Teen Essay Contest is open to 9 th-12th grade students in the Coachella Valley. The goal of the contest is to provide a forum for teens to express their experiences with cancer, and to raise awareness in the general population about the impact of cancer on teenagers. The essay may describe the experience and feelings of a teen with cancer or a teen who has a close relative or friend with cancer.

Release
For good and valuable consideration, I hereby grant permission to Gildas Club Desert Cities and the Cancer Support Community, to use, publish and reproduce my name, approved image, and essay submission in print and electronic media, including but not limited to, brochures, annual reports, presentations, newsletters, direct mail, articles about Gildas Club, and other fund-raising and marketing materials, to promote the above Its Always Something Teen Essay Contest throughout North America. Agreed and Accepted by: Student Signature: _______________________________________ Date: _______________ Student Name [please print]: ___________________________________________________ If student is under the age of 18, the consent of a parent or legal guardian is also required: Parent Signature: ________________________________ Date: _______________

Parent Name [please print]: ______________________________________________

The Mission of Gildas Club Our mission is to ensure that all people impacted by cancer are empowered by knowledge, strengthened by action, and sustained by community.

Gildas Club Desert Cities 67-625 E. Palm Canyon Dr., Ste. 7A Cathedral City, CA 92234