Kid of the Month Entry Form
(Please fill out completely)
To nominate a Radio Disney Kid of the Month:
- Print
out this page and fill out the entire form. If you don't have a
printer, write the information on a separate piece of paper (please
print).
- VERY IMPORTANT: Please read the rules.
- Mail your form to:
Radio Disney Kid of the Month Contest
P.O. Box 802626
Dallas, TX 75380
Winning
nominees (ages 14 and under) will be those whose deeds both enhance and
show the goodness of the child's character by making a contribution to
education, family, community, and/or environment. Judges will look for
demonstrated initiative of the child that is above and beyond the
expected.
Name of Nominee:_____________________________________________
LAST FIRST
Name of Parent/
Legal Guardian: _____________________________________________
LAST FIRST
Address: ____________________________________________________
____________________________________________________
STREET ADDRESS APT. #
City:________________ State:__________ Zip code:___________
Parent/Legal
Guardian's
Home Phone:__________________ Daytime Phone:_________________
(AREA (AREA
CODE) CODE)
Age of Nominee:_____ Birthdate of Nominee:_____/______/______
MONTH DATE YEAR
Description of Deed:(50 words or less)
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
No purchase necessary. Void where prohibited. Kids 14
and under are eligible to be nominated as Radio Disney's Kid of the
Month, a monthly feature recognizing a child as a hero for putting
forth an extra effort. Child selected as Kid of the Month will win a
"Kid of the Month" trophy and a prize as announced on-air. Anyone can
nominate a child for the contest. A child may not nominate him/herself.
Entries must be submitted ONLY via mail to Radio Disney Kid of the
Month Contest, P.O. Box 802626, Dallas, TX 75380. Valid entries must be
legibly written in pen or typed on a postcard or 8.5" x 11" piece of
paper and include all of the following information: a description of
the deed performed (IN 50 WORDS OR LESS), the first and last name, and
area code and phone number of the child who performed the deed, plus
his/her address, city, state, zip code, and age. The entry must also
contain the first and last name of the nominating person, his/her day
and nighttime phone number(s) with area code, and
relationship/connection to the nominated child. Only children who are
14 years of age or under at time of nomination and legal residents of
the continental United States, Hawaii, and Alaska are eligible to win
Kid of the Month. No one who is nominated or who is nominating another
person can be an employee of Radio Disney, ABC Radio Networks, ABC,
Inc., affiliates of Radio Disney, Disney Enterprises, Inc., and its
subsidiary companies, their corporate licensees, affiliated advertising
agencies, or participating sponsors/promotional partners, or be a
member of the immediate family of anyone so employed. Deed must have
been performed by the child within the last 12 months. If this deed is
not verified by parent/guardian and nominated child to the satisfaction
of Radio Disney, the entry will be disqualified. Kid of the Month will
receive a total prize package with approximate retail value of $800 -
$1,500 to be announced on-air. Some restrictions may apply. Payment of
all federal, state, and local taxes is the sole responsibilit of the
winner. To obtain a copy of the rules, send a self-addressed stamped
envelope to Radio Disney Kid of the Month Rules, P.O. Box 802626,
Dallas, TX 75380. To obtain a list of Kid of the Month Winners over the
past 12 months, send a self-addressed stamped envelope to Radio Disney
Kid of the Month Winners' List, P.O. Box 802626, Dallas, TX 75380.
Nominated By: _______________________________________________
(NAME) LAST FIRST
Address: ____________________________________________________
STREET ADDRESS APT. #
____________________________________________________
CITY STATE ZIP CODE
Home Phone:__________________ Daytime Phone:_________________
(AREA (AREA
CODE) CODE)
Your Relationship to Nominee:________________________________
(PARENT, GUARDIAN, RELATIVE,
TEACHER, FRIEND, SIBLING, OTHER)
Your Signature: _____________________________________________
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