OFFICIAL ENTRY FORM - USE ONE FOR EACH PHOTO

 2010 Umpqua River Lighthouse Photo Contest



Name ______________________________________________

Address ____________________________________________

City _________________________ State ______ Zip _______

Photo Category: (check box)
[  ] STANDARD    or     [  ] ARTISTICALLY    ALTERED

Title of Your Photo: (if any)              _______________________________________________

[  ] $5.00 Entry Fee Enclosed, Payable to:
    Friends of Umpqua River Light Photo Contest

[  ] By checking this box, I confirm I have read,  
I understand, and agree to be bound by the   Contest Rules of the 2010 Friends of Umpqua River Light Photography Contest.

Signature __________________________________ 
     
Date ___________________

                             Send To:  
              Friends of Umpqua River Light 
                   1020 Lighthouse Rd.
                Winchester Bay, OR 97467