Hope the Husky's "Healthy is..." Bookmark Coloring Contest

* 8. Terms and conditions agreement: By clicking, "I agree to the terms and conditions", I am authorizing the Department of Health to use, release and re-release the information, video, audio, photograph or other media that I upload or send as described above. I understand that this consent is voluntary. I understand that my refusal to sign will not affect the ability of the participant to obtain treatment, payment, eligibility for benefits or other services from the Department of Health.

I understand the stated purposes for the use or release of the information or other media as described above. I also understand that the information or media described above WILL BE MADE PUBLIC AND MY IDENTITY MAY BE DISCLOSED. I understand the information or media is no longer protected by federal or state privacy regulations once I have consented to its use and release. I relinquish all rights, title and interest to the information or other media as described above. I understand that I may request a copy of this signed consent.

If submitter is under 13 years old, I am the parent or legal guardian of the participant. I consent to the participant’s entry in the Bookmark Coloring Contest. I authorize the Alaska Department of Health to use, release, and re-release the submitted artwork, name (first name and last initial), grade level, and community for the purposes of promoting the contest and sharing selected entries with the public. I understand this information may be made public and will no longer be protected by federal or state privacy laws once released. I understand participation is voluntary and refusal will not affect eligibility for services. I hereby release all rights, title, and interest in the submitted artwork to the Alaska Department of Health