Entry Form

Please Type
(and use the browser's Print to print out):

Teacher Photocopied entry forms are acceptable.
Postmark deadline is Saturday,
October 23, 2004.

Mail entries with entry form to:
California Department of Boating & Waterways Safe & Wise Water Ways Contest
2000 Evergreen Street, Suite 100
Sacramento, CA 95815-3888

Phone #
Email address

List of Entrants
Name Grade Name Grade

Signature of Teacher

I hereby certify all posters were composed by the students named above and I understand all entries become the exclusive property of the California Division of Boating and Waterways. The Department has the right to display or otherwise use the submissions and modify any poster for future reproduction. The poster entries cannot be returned.