2008 Líderes de Hoy National Essay Contest Release Form All students must mail in a signed release form. Only incoming college freshmen must fill in the high school information portion. Please read the following release and sign where indicated. The signed release must be mailed. (You can submit your essay electronically.) As a condition of entering the Líderes de Hoy essay contest, I hereby certify that: • I am the author of the essay submitted to the Líderes de Hoy essay contest. • I am the sole and exclusive owner of all rights thereto and there are no disputes regarding ownership of the submission. I have full authority to submit the essay to the Líderes de Hoy essay contest. • I guarantee that the submitted essay does not invade or defame the rights of any person living or dead, and I fully indemnify Allstate Insurance Company and the National Council of La Raza (NCLR) against any claim made for such invasion, defamation, or other violations of law. • I will indemnify, defend, and hold harmless the Líderes de Hoy essay contest, Allstate, NCLR, its employees, and judges, individually and collectively, including their heirs, personal representatives, officers, directors, successors, and assigns, from and against all claims, demands, losses, damages, costs, judgments, liabilities, and expenses (including attorney’s fees) arising out of or in connection with any and all claims of third parties, whether or not groundless, based on any essay or other materials submitted by me to Allstate, NCLR, and/or the Líderes de Hoy essay contest. • I hereby grant Allstate and NCLR the nonexclusive right to use my name, photograph, and likeness in connection with any and all publicity and promotional activities regarding Allstate, NCLR, and/or the Líderes de Hoy essay contest. • I understand the Líderes de Hoy essay contest accepts no liability whatsoever for loss or nonreceipt of my essay or for the unauthorized use of all or part of my essay by any person and I agree to remain fully liable in connection therewith. • I understand that the Líderes de Hoy essay contest will not return and is not obligated to return my essay, or any other materials that I have submitted to the Líderes de Hoy essay contest. • I hereby agree to abide by the decisions of the Líderes de Hoy essay contest judges with regard to all matters and decisions, including those decisions involving their sole discretion relating to the Líderes de Hoy essay contest. • I have read all of the competition rules, regulations, and release and I understand them and have complied with them. • I understand that failure to adhere to the Líderes de Hoy essay contest rules, regulations, and release will result in disqualification.
Title of Work __________________________________ Date_____________________ Applicant’s Signature ____________________________ Print Name________________
Guardian’s Signature ____________________________ Print Name________________
Only incoming college freshmen must fill in the high school information
Líderes de Hoy Essay Contest High School Information Please read the following release and sign where indicated. The signed form must be mailed. High school Principal or Assistant Principal: Please provide the following information regarding the applicant and his/her high school. Applicants must anticipate enrolling in college in the fall of 2009. GPA (on 4.0 scale) ________ (minimum 2.0 GPA) Confirmed Graduation Date: ___ /___ /_______ City ____________________ State __________ Official High School Name: ___________________________________________________________________ (_____) ____________________ School Phone Number ______________________ Principal Signature
(____ ) _____________________ School Fax Number
______________________________________ Printed Name (Salutation, First and Last Name)
_______ Date
High school seniors applying for the scholarship must submit via mail the following: • release form • high school information form • letter of recommendation Mail to: Líderes de Hoy Essay Contest Attn: Denise Pernick 1126 16th Street, NW Washington, DC 20036 Faxes and emails for the release forms and recommendation will not be accepted.