To Be Completed and Attached To Back Of Each Piece Of Art Work

Description of Artwork_________________________________________

Student Name________________________________________________

School______________________________________________Grade______________

Address________________________________________________________________

City_______________________________State_________________Zip_____________

Phone Number__________________Cell Number ___________________

 

Email Address_______________________________________________

Parent / Legal Guardian________________________________________

 

I give permission to the Smokin’ Red Dirt Arts Festival to exhibit the work of the above named student at the Youth Art Show on April 20-21, 2012.

Parent / Legal Guardian Signature_________________________________

Date______________