spooky scribbles entry form

CONSENT - FOR THE ADULTS

By submitting your story, you give Vancouver Island Regional Library, the Comox Valley Lifelong Learning Centre and the Comox Valley Record non-exclusive permission to use content of and/or made by the participant for digital or print publications. You understand that this may include, but is not limited to, social media posts, websites, newsletters, advertisements, posters and pamphlets. You also understand that on occasion photos, video, audio, or publications may be shared with media outlets and community partners for use in promotions of Library or community agency events, initiatives, and stories. You certify that no other person's permission is needed to authorize the use of said images or content. You agree that the Vancouver Island Regional Library, the Comox Valley Lifelong Learning Centre and the Comox Valley Record cannot be held liable for images or content used with your consent.

Parent / Guardian's Name

First Name

Last Name

Parent / Guardian's consent

By checking the box below, I agree to the terms and conditions of the Spooky Scribbles Contest, and understand that my child's work may appear publicly in print and online media.

I agree

Child's Name

First Name

Last Name

Age

How old are you?

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Ask to use an adults if you don't have your own!

What did you write?

Poem

Story

Is this...

My original idea

A retelling of someone else's story

If this is a retelling of someone else's story, tell us a little about where you first heard it

Title

Please write the Title of your story or poem here

Your Spooky Scribble

Cut and paste your writing here

spooky scribbles entry form

Want to submit your story by hand?

Drop it off at the VIRL Branch closest to you!