Lake County America 250 Photo Submission Form Survey

As part of America 250 in Lake County, we are inviting residents to help tell our county’s story through photos, celebrating the 250th anniversary of the United States and the history that defines Lake County.

If you submit three or more photos and one of them is selected to be used as part of our America 250 celebration, you will be eligible to receive a commemorative Lake County America 250 button!

Photo Upload

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Photo Description

Photo Upload (Optional)

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Photo Description

Photo Upload (Optional)

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Photo Description

Photo Upload (Optional)

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Photo Description

Photo Upload (Optional)

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Photo Description

Authorization(Required.)

I hereby authorize Lake County, Illinois, to use, reproduce, publish, distribute, adapt and publicly display the photos submitted of the person named below for purposes related to the Lake County America 250 celebration.

Name and Signature(Required.)

Name

Signature

Contact Information (Required to Be Eligible for a Commemorative Button)

Street Address

City

Zip Code

Email Address

Certification and Release(Required.)

I hereby certify and represent that, any typed signatures above serve as electronic signatures, I agree to the photo submission rules, and to the best of my knowledge, the photos submitted by the person named above is an original work, and that it is not copied from, nor does it include, any other person’s copyrighted work in part or in whole. I further affirm that the photo was not created using any generative artificial intelligence (AI).