Healing Field Poetry Contest 2011

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Healing Field Poetry Contest 2011
 Healing Field® Poetry Contest 2011
Presented by: 1300 A Bay Area Blvd., Ste. 102 Houston, Texas 77058 1.800.510.3111 toll free | 281.212.2900 main www.bacoda.org | www.bacodablogs.com Healing Field® Poetry Contest 2011
Background on BACODA & Healing Field® Bay Area Council on Drugs & Alcohol (BACODA) is a 501(C)3 non-­‐profit organization and United Way agency. BACODA was founded in 1974 by a group of concerned parents, business people, medical professionals, and civic leaders in order to establish a centralized clearinghouse for information on drug and alcohol abuse and to reduce the prevalence of these diseases in the Texas Bay Area. Our mission is to help individuals, families and communities stop alcohol/drug abuse and addiction. The Healing Field® program started out as a way to commemorate the lives of those lost to us on September 11, 2001. Since the first Healing Field® display in 2002, hundreds of communities across America have hosted a Healing Field® or Fields of Honor to raise money and awareness for a growing array of causes. These special displays of fields of American flags have helped to honor the sacrifice of our service men and women, raise awareness for the tragedy of child abuse or domestic violence, honor veterans past and present, raise awareness for heart disease and cancer and more. BACODA will bring awareness to the fatal results of drinking and driving with our Fourth Annual Healing Field® Event from November 11-­‐15, 2011. There will be 1,551 3ft X 5ft U.S. flags flown in memory of each individual that was killed in an alcohol related crash in the State of Texas in 2009. The acres of red, white, and blue will serve as a visual reminder of the deadly consequences of drinking and driving. “We want this event to raise awareness of the enormity of the problem. Awareness builds strength in a community – a strength that can bring about social change,” said Karen Van Horne, CEO of BACODA. Statistical Data: • 2008 Texas Data: o 3,382 total accident fatality accidents o 1,616 of the total were alcohol related Texas leads the nation in alcohol related fatality crashes. Harris County leads the State. Visit www.bacoda.org and click on the Healing Field® tab for additional information on BACODA’s Healing Field®. Healing Field® Poetry Contest 2011
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You must be enrolled in high school in the four counties we serve: Harris, Brazoria, Galveston or Matagorda. You must be still enrolled in high school in the 2011-­‐2012 school year. You must be a legal resident of the United States to be eligible. You must NOT be employed by BACODA, related to a BACODA staff member or board member to be eligible. Contest Guidelines •
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The deadline for all submissions is November 4, 2011 at 5p.m. o All submissions must either be received by (a) your school representative; (b) by BACODA staff at the Clear Lake Office, 1300A Bay Area Blvd, Ste. 102, Houston, Texas 77058, or (c) emailed directly to [email protected] with “HF Poetry Entry” in the subject line by the deadline. All parts of the entry form must be completed, including all required initial and signatures sections. Any entry that is not complete in its entirety will be discarded by the judging panel. In addition to the application form, you must include a signed copy of the Media Release Form in order to be eligible for the contest. The poem submitted must be your original work, and no one else may claim ownership of the entry. There is one poem entry per contestant. Please do not submit multiple entries. The poem submitted must be presented in its entirety, including all expletives, formatting or page length. There is no length or page requirement for this contest. The poem submitted may be presented in any style, including but not limited to: ballad, couplet, free verse, haiku, limerick, monody, palindrome, pantoum, shape, etc. Judging Process •
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Once received by the deadline, all entries will be reviewed by a panel of six (6) judges, employed or associated with BACODA. The judges will review all applications and ensure they meet all guidelines before they are considered acceptable entries. (Any entry that is not complete in its entirety will be discarded by the panel.) Once vetted for completion of the application, the panel will review the poems and judge them based on the following criteria: o Message: Does the poem follow the message of BACODA’s Healing Field®? o Creativity: Does the poem show creativity in its presentation? o Voice: Does the poem reflect the voice of the submitter/character/audience it is describing? o Originality: Is the poem the original, sole work of the submitter? o Style: Is the poem presented in a style that reflects the intended message of both the submitter and BACODA’s Healing Field®? Winning Entries •
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Winners will be contacted by BACODA during the week of November 7, 2011. BACODA will award prizes to 1st Place, 2nd Place, 3rd Place and Honorable Mention winners. Winning entries will receive recognition on www.bacoda.org. They will also be presented with an award at the Healing Field® Opening Ceremony and recognition in the program guide this November. All winning entries will receive a certificate of award. The three runners-­‐up will receive a $50 VISA gift card. The 1st Place winner will receive a $100 VISA gift card. Healing Field® Poetry Contest 2011
DEADLINE: November 4, 2011 *** EMAIL COMPLETED ENTRY FORM, WITH SIGNATURES, TO [email protected] OR RETURN ENTRY FORM TO YOUR TEACHER BY THE DEADLINE. Applicant Information Full Name: First M.I. Address: Street Address Apartment/Unit # City State Zip Code Last Home Phone: Alternate Phone: E-­‐mail Address: School: Grade Level (circle one): 9 10 11 12 Teacher: Poem Title: Release of Information The undersigned “Submitter” hereby submits the Healing Field® Poem, (Title of Poem) for purposes of consideration by the Bay Area Council on Drugs & Alcohol, Inc. (“BACODA”) for contest purposes. The undersigned agrees that, in exchange for contest consideration, any and all legal rights of title and ownership in the submitted project (including copyright protections) shall become the legal right of BACODA to have free use of such project for any and all purposes for which BACODA shall see fit, without any further obligation to submitter. BACODA agrees to give said submitter attribution for their work in all works we see fit. The undersigned hereby attests that: this poem was the sole creation of the Submitter and that no other person has any right to claim ownership of such poem; and this poem has not been published in any publication. Please initial the following: _________ Yes, I am the sole creator of the attached poem. _________ Yes, I have signed, completed, and attached a copy of the Media Release Form. By signing and dating this entry form you agree to the terms and conditions described above, AND in the Media Release Form. BACODA retains the right to reproduce your work, with attribution when we see fit, on our website, blog, other promotional materials, or otherwise. If you are under 18, a parent/guardian signature is also required on this entry form AND on the Media Release Form. Applicant’s Signature Date If under 18, Parent/Guardian’s Signature Date Healing Field® Poetry Contest 2011
DEADLINE: November 4, 2011 *** EMAIL COMPLETED ENTRY FORM, WITH SIGNATURES, TO [email protected] OR RETURN ENTRY FORM TO YOUR TEACHER BY THE DEADLINE. Poetry Submission If submitting electronically, please use the following space to write your poem. You may use additional pages if needed. 281-­‐212-­‐2900 | 1-­‐800-­‐510-­‐3111 | www.bacoda.org Media Release Form By signing this form, I _____________________________ am granting permission to the Bay Area Council on Drugs & Alcohol (“BACODA”) to make films, videotapes, and/or photographs of my child or myself and to reproduce such films, videotapes or photographs (including portions thereof) for public showing on television, in slide or videotape, or for publication in newspapers, newsletters, brochures, BACODA’s Web site, or otherwise. It is understood that such films, videotapes, and/or photographs may be used for news, community affairs, and/or promotional materials or presentations for BACODA. I hereby waive any right to inspect or approve the finished photographs or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the photograph. I agree to release, defend, and hold harmless BACODA including any firm publishing and/or distributing the finished product in whole or in part, whether on paper or via electronic media, from and against any claims, damages or liability arising from or related to the use of the photographs, including but not limited to any misuse, distortion, blurring, alteration, optical illusion or use in composite form, either intentionally or otherwise, that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution. Please check the paragraph below which is applicable to your present situation: ______I am 18+ years of age and I am competent to contract in my own name. I have read this release, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the term of this release. _____I am the parent or legal guardian of the below named child. I have read this release, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release. I agree to allow BACODA to use these films, videotapes, and/or photographs without financial remuneration, and I understand that this releases BACODA from any future claims, as well as from any liability arising from the use of said films, videotapes, and/or photographs. Parent or Guardian must sign this form if the participant is a minor. ____________________________________________ ____________________________________________ Name of Child School ____________________________________________ ____________________________________________ Address Signature of Adult/Parent/Guardian ____________________________________________ ____________________________________________ City, State, Zip Date
281-­‐212-­‐2900 | 1-­‐800-­‐510-­‐3111 | www.bacoda.org Formulario de Autorización de los medios de comunicación Al firmar este document, afirmo que yo soy,________________________________ para conceder autorización al Concilio de Alcohol y Drogas de Bay Area, BACODA, para hacer películas de cinta, videos, fotografías de mi hijo/hija o de mi mismo. Incluso para su exhibición publica, en la televisión, y videos. También publicación en periódicos, bolentines, folletos, sitio web de BACODA o de otra manera. Esta entendido que estas gravacions seran utilizadas para noticias, asuntos de la comunidad, y/o para promociones, precentaciones para el uso the BACODA. Por este medio renuncio cualesquier derecho de inspeccionar or aprobar las fotografias terminadas, impresas o electronicas, asunto que pueda ser utilizado, en ningun mommento, en el futuro que el uso es conocido o desconocido para mi. Tambien renuncio a cualesquier derecho de las regalía o compensaciones derivadas de uso relacionadas con las fotografías. Estoy de acuerdo en liberar, defender y mantener me inoffensive a BACODA incluyendo cualesquier firma editorial que distribuya el product terminado total o parcial, ya sea en papel, por medios electrónicos, cualesquier reclamo, dano o responsabilidad que surja con lo relacionado y, el uso de las fotografías, incluendo pero no limitado a cualesquier uso indebido, distorsión, desenfoque, alteraciones, ilusión óptica y la utilización en formas compustas. Por favor, consulte el siguiente párrafo que es aplicable a su situación actual: ______I Tengo 18 años de edad y soy competente para contratar en mi propio nombre. He leído este comunicado, y entiendo perfectamente el contenido, significado e impacto de esta liberación. Yo entiendo que soy libre para hacer frente a cualquier pregunta específica acerca de esta versión mediante la presentación de las preguntas por escrito antes de la firma, y estoy de acuerdo que si yo no lo hago, se interpretará como una aceptación libre e informado del término de este comunicado. _____Yo Soy el padre o tutor legal del niño menor de nombre. He leído este comunicado, y entiendo perfectamente el contenido, significado e impacto de esta liberación. Yo entiendo que soy libre para hacer frente a cualesquier pregunta específica acerca de esta versión mediante la presentación de las preguntas por escrito antes de la firma, y estoy de acuerdo que si yo lo hago se interpretará como una aceptación libre e informado de los términos de este comunicado. Estoy de acuerdo en permitir que BACODA utilizar estas películas, cintas de vídeo y / o fotografías sin ninguna remuneración financiera, y entiendo que BACODA exime de cualesquier reclamo en el futuro, así como de cualesquier responsabilidad derivada del uso de dichas películas, cintas de vídeo, y fotografías. Padre o tutor debe firmar esta forma si el participante es menor de edad. ____________________________________________ ____________________________________________ Nombre del niño
Escuela ____________________________________________ ____________________________________________ Dirección
Firma de un adulto/padre/tutor ____________________________________________ ____________________________________________ Ciudad, Estado, Código Postal Fecha

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