Piggy Bank Entry Form

    Parent/Guardian's Email (required)

    Child's Name (required)

    Parent/Guardian's Name (required)

    Parent/Guardian's Phone (required)

    Child’s School/Organization (required)

    Town/City where School/Organization is Located (required)

    Child’s Grade in School (required)
    3rd Grade4th Grade5th Grade6th Grade

    Child’s Teacher (required)

    Entry Category (Check ONE) (required)
    FunniestPrettiestMost Athletic (Sport)Most Popular (Celebrity)

    Savings Statement: Use this space to explain what you want to save for and why? Please limit to space provided. (required)

    Release Form for Media Usage

    I, the undersigned, do hereby consent and agree that the Idaho Financial Literacy Coalition, its members, or agents have the right to
    take photographs, video, or digital recordings of me and/or my child listed on this Entry Form in perpetuity beginning today and to use these in any and all media, now or hereafter known, and exclusively for the purpose of promoting Idaho’s Piggy Bank Beauty Contest, in conjunction with America Saves Week and Idaho Financial Literacy Month, or the financial education promotional efforts of the Idaho Financial Literacy Coalition. I understand that my name and identity, and that of my child listed on this Entry Form, may be revealed therein or by descriptive text or commentary.
    I do hereby release to the Idaho Financial Literacy Coalition, its agents, and members all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness and those of my child listed on this Entry Form in whatever media used. I understand that there will be no financial or other remuneration for recording me or my child listed on this Entry Form, either for initial or subsequent transmission or playback.
    I also understand that the Idaho Financial Literacy Coalition is not responsible for any expense or liability incurred as a result of my participation or that of my child listed on this Entry Form in this recording, including medical expenses due to any sickness or injury incurred as a result.
    I represent that I am at least 18 years of age and that I am the legal parent and/or guardian of the child listed on this Entry Form, have read and understand the foregoing statement, and am competent to execute this agreement.

    Date (required)

    Street Address (required)

    City/State/Zip (required)

    By typing your name in this box, you are providing a digital signature, and acknowledge that you are accepting the terms of this form. (required)

    Type in the characters