Photo Contest Entry Form

First Name (required)

Last Name (required)

Mailing Address (required so I have an address to send Certificates/Prizes):

Street (required)

City (required)

State/Province (required)

Zip/Postal Code (required)

Your Email (required)

Phone Number

Any Additional Message

Here is my entry for the Thirteenth Custom Clinic Photo Contest! I understand that my photos and written descriptions become the property of the International Model Car Builders’ Museum and may be used in any capacity, including the feature article in Model Cars Magazine and on Mark S. Gustavson’s Custom Clinic site, without compensation to the entrant, author or photographer who is presumed to have released his/her copyright by the act of submitting photographs. The sponsors, the Museum and Model Cars Magazine may use my photos for the photos for advertising, editorial, and public relations purposes, and will not be returned. I agree to abide by Contest Rules and I understand that all decisions are final.

If I am a Junior Class Entrant, my Parent or Guardian will sign this Entry Form on my behalf:

I have read and agree to the conditions above.
Please note this form will not submit until this box is checked.

Individual files can be no larger than 1MB and must be in one of the following formats: .jpg, .jpeg, .png, .gif.