2015 LITERARY CONTEST APPLICATION AND WAIVER
Personal information
Name (First & last): __________________________________________________________________________ Age: __________
May we list your age in the published novel if you are a winner? Please select one: [Y] [N]
Date of application: ____________________ Address: ___________________________________________________________
City: __________________________________________ State: ________________________________ Zip code: ______________
Email address: ________________________________@_________________ Phone number: __________________________
Title of entry: _________________________________________________________________________ Word count: _________
Rules for submission:
1. All ages are welcome to submit entries. Authors under the age of 18 must have a parent or
guardian co-sign the waiver below.
2. Multiple entries are allowed. However, it is a $25 donation per individual submission, and
each author is eligible to have one entry published.
3. Submissions should be free of foul language. (Please check with us if your writing contains
certain words that are questionable.)
4. Submissions should not be negative or discriminatory with regards to race, ethnicity, sex,
sexual orientation, religion, age, national origin, or disability.
5. Submissions must relate to the theme specified below.
6. With regards to rules 3, 4, and 5, all inappropriate entries will be disqualified and the $25
application fee/donation will not be reimbursed.
7. Submissions should not exceed 1,000 words.
8. Submissions must either be printed or emailed via a Word document. Handwritten
submissions will not be accepted.
9. Submissions should be the author’s original work! No plagiarism will be tolerated.
RANCHO TIERRA MADRE
27115 N. 45TH ST.
CAVE CREEK, AZ 85331
480.469.9166
2015 LITERARY CONTEST APPLICATION AND WAIVER
Submission theme
All entries should relate to the following theme:
“How have horses helped me on my life journey?”
We picked this general theme for a reason – we want you to be honest, thoughtful, and creative!
Whether you want to write a short story, an essay, a blog post, a poem, lyrics, a narrative, or
whatever, this is your time to shine.
Contest rules and guidelines
1. ALL ENTRIES ARE DUE TO TIERRA MADRE HORSE SANCTUARY BY 11:59pm ON
SATURDAY, APRIL 4.
2. 25 WINNERS WILL BE CHOSEN BY SATURDAY, APRIL 11.
3. WINNERS WILL BE CONTACTED VIA EMAIL ON APRIL 11TH AND WINNERS WILL BE
ANNOUNCED ON FACEBOOK ON APRIL 12TH.
4. ENTRIES CAN BE EMAILED TO TIERRA MADRE’S RANCH DIRECTOR AT:
alexisroeckner@gmail.com
OR MAILED TO TIERRA MADRE AT:
Attn: Alexis Roeckner
27115 N. 45th Street
Cave Creek, Arizona 85331
5. IF YOU ARE EMAILING THE APPLICATION, PLEASE WRITE “Tierra Madre Literary Contest
Submission” IN THE SUBJECT LINE.
6. APPLICATION FEES CAN BE PAID BY VISITING OUR WEBSITE AND CLICKING “DONATE”
OR BY MAILING A CHECK TO THE ABOVE ADDRESS WITH YOUR SUBMISSION. THE CHECK
SHOULD BE MADE OUT TO TIERRA MADRE HORSE SANCTUARY.
RANCHO TIERRA MADRE
27115 N. 45TH ST.
CAVE CREEK, AZ 85331
480.469.9166
2015 LITERARY CONTEST APPLICATION AND WAIVER
PLEASE READ CAREFULLY BEFORE SIGNING. THIS IS A WAIVER OF CERTAIN LEGAL RIGHTS.
In consideration for the opportunity to submit my literary submission to participate as an applicant in the 2015
Literary Contest, sponsored by Tierra Madre Horse Sanctuary, I irrevocably give Tierra Madre Horse Sanctuary and
its agents and contractors the right and permission to use, copy, alter, distribute, publish, broadcast, and display the
literary work that I have submitted; photographs and images of me that I have provided or that they will create; my
voice and likeness; my name; the city, state, or province in which I live; and other information and material included
in my Entry Application, on Tierra Madre Horse Sanctuary’s website, elsewhere on the Internet, in advertising and
promotional materials (such as on Facebook), and in any other medium or format for any purpose related to the 2015
Literary Contest.
I acknowledge and agree that if I am selected as a finalist for the 2015 Literary Contest, Tierra Madre Horse
Sanctuary may post my literary submission on the Internet. I waive any right to royalties or other payment for the
use of my literary submission and I also waive the right to inspect or approve Tierra Madre Horse Sanctuary’s use of
my literary submission and other materials that Tierra Madre Horse Sanctuary may use with my submission. I attest
that there is no copyrighted material in my literary submission. I release and waive and agree to hold Tierra Madre
Horse Sanctuary, its agents, and its contractors harmless from any claims, damages, or liabilities resulting from their
use of my literary submission and I agree not to bring any such claims against the released parties at any time in the
future. This includes, but is not limited to, claims for violation of publicity rights and privacy rights, claims based on
moral rights, claims for intrusion, claims for defamation, claims for fraud, claims for infliction of emotional distress,
and claims for copyright or other intellectual property infringement, whether those claims may be based on statutes
or the common law.
I represent and warrant to Tierra Madre Horse Sanctuary that: The literary submission is my original work. I have
the full right and authority to execute this Release and Waiver. If I am under the age of 18 I will have a parent or
guardian co-sign this waiver. I have all rights necessary to grant the rights, waivers, and releases granted in this
Release and Waiver. I have read this Release and Waiver and I fully understand it. All statements and information
included in my Entry Application and any other statements and information that I provided to or will provide to
Tierra Madre Horse Sanctuary are true and complete to the best of my knowledge.
I acknowledge that my $25 application fee (per entry) is nonrefundable despite the outcome of the contest. I
acknowledge that if I am selected as a winner, I will receive one (1) free book of all published submissions.
PRINT NAME: _______________________________________________________________________________
SIGNATURE: ________________________________________________________________________________
PARENT OR GUARDIAN’S PRINTED NAME: ____________________________________________________
PARENT OR GUARDIAN’S SIGNATURE: ________________________________________________________
DATE: ______________________________________________________________________________________
RANCHO TIERRA MADRE
27115 N. 45TH ST.
CAVE CREEK, AZ 85331
480.469.9166