7th Annual Whiz Chips

Klik and Play/Multimedia Fusion Contest Application

Apply in Dr. Data’s room by Friday, April 28

Contest dates are: Monday, May 8; Tuesday, May 9; and Thursday, May 11.

Name: _________________________________ Grade Level: _____ Team _______

E-mail Address: __________________________________ Home Phone: ____________________________

Address: _______________________ City: ___________________

Software Applications: Kick & Play or Multimedia Fusion (circle one)

I will attend all three days of the competition: yes or no (circle one)

Monday, May 8, 2006

Tuesday, May 9, 2006

Thursday, May 11, 2006

I will obey all contest rules pertinent to the software application entered in. Yes or No (circle one)

Student Signature is required to be in the contest:

I, ___________________________________________, (please print name here, _________________________________) certifiy that I will comply with all contest ruls and expectation as outlined on: http://www.kuzmich.com/carmody/whiz_chips_intro.html

Parent signature is required because there may be some video taping for video streaming the contest over the Internet after the contest is over. And only students who have parental permission to have their child video taped can be used in the video streaming. If the parent doesn't want their child video taped, they will not.

I, ________________________, as a parent/legal guardian for (print child's name, ______________________) give permission to have my child video taped during the 6th Annual Klik & Play Contest for possible video streaming over the Internet after the contest is completed.