Pinckneyville Community Hospital : 2019 Photo Contest

2019 Photo Contest
Professional and Amateur Photographers Wanted Pinckneyville Community Hospital would like to decorate our walls, and we want YOUR help! We want the art in our hospital to reflect the people, places, events and overall beauty of Perry County and Southern Illinois. Whether you are professionally trained or just a youth or adult who enjoys taking photographs on your phone - we want to see your work!
Please refer to the official rules at www.pvillehosp.org. Release Photograph, Testimonial and Marketing Release Form If you have any questions, problems, or concerns, please direct them to Jennifer Barbour at 618-357-8898 or jbarbour@pvillehosp.org.
*	Photographer First Name
*	Photographer Last Name
*	Photographer Street Address
*	Photographer City
*	Photographer State
*	Photographer Zip Code
*	Photographer Phone Number
	Photographer Email
*	Is the Photographer 17 years old or younger?	Yes No
	If Photographer is 17 years old or younger, please list parent/guardian first and last name
*	Photo Category	Natural World Architecture People Southern Illinois Experience
*	Photo Title Please share a name for your photo, or include where the photo was taken.
*	Photo
	Consent Form For a photo in which a person is recognizable, you must provide consent from the subject or, in the case of a minor, the subject's parent or guardian. A copy of this form may be found on the main contest page at www.pvillehosp.org. Forms may also be mailed to Marketing @ Pinckneyville Community Hospital \| PO Box 437 \| Pinckneyville, IL 62274.