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ADG: ACHIEVE-THE-DREAM™
Children's Story Writing Contest

Contest Application

Please print out application and mail to the address below.

First Name: _________________Last Name:______________________MI: __

Address:________________________________________________________

City: _________________________State: _________ Zip Code: _________

Country:________________________________________________________

Home Phone: (__________)________________________________________

Work Phone: (___________)________________________________________

Email Address (if any)_____________________________________________

How did you learn of the Competition?:_______________________________

Title of Story: __________________________________ No. Words: _______

Reader Age Category (circle one)     0-5     or       6-10

Please notify us by mail if you change your mailing address before
July 15, 2006. The following information is for statistical purposes only;
it will not be seen by judges and will not affect the judging process in any way:

Female             Male                            Author Age: ___________

RELEASE

My signature below attests:

1. To the accuracy of the information supplied above.
2. That the material submitted is my sole and original work.
3. To my agreement to hold the ADG: ACHIEVE-THE-DREAM™ Children's Story Writing Contest and The American Dream Group, Inc.™, its agents, employees, partners, successors and assigns harmless from and defend them against all claims, demands, losses, costs, damages, judgments, liabilities and expenses (including attorney's fees) arising out of or in connection with any and all claims of third parties, whether or not groundless, based on any stories submitted to the ADG: ACHIEVE-THE-DREAM™ Children's Story Writing Contest or any manuscript, novel play or film developed out of such stories.
4. That I understand that if the ADG: ACHIEVE-THE-DREAM™ Children's Story Writing Contest, The American Dream Group, Inc.™ desires to acquire my manuscript for commercial use; a separate Publishing Contract. will require future approval and agreement by the parties at that time.
5. To my understanding of the purposes, rules, guidelines and conditions of the ADG: ACHIEVE-THE-DREAM™ Children's Story Writing Contest and to my acceptance of them.

Signature of Applicant:___________________________________________      Date:_________

***********************************************

Postmarked by the Entry Deadline of July 15, 2006; a completed application/release form, two copies of the manuscript and a $25.00 U.S. entry fee (in form of a check or money order made payable to The American Dream Group, Inc.) should be sent to:

ADG: ACHIEVE-THE-DREAM
Children's Story Writing Contest
P.O. Box 1137
Moon Township, PA 15108

This form may be printed, photocopied, or electronically reproduced.

***No Fee Option. You may enter this contest without paying an entry fee of $25.00. If you choose this option, all of the prizes, minus the cash award, will still be paid. All entries will be judged together, and the judges will not know who paid a fee.

If you choose to send in your entry with out the $25.00 fee, please acknowledge your understanding of the rules, specifically that if your story is selected as the winner, you will NOT receive the cash prize, by initialing here_____________.

"The reward for work well done is the opportunity to do more."
- Jonas Salk