Canada Day Challenge Entry Form

Download a blank fillable Canada Day Challenge Entry Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Canada Day Challenge Entry Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

FOR OFFICE USE ONLY
Protected A when completed
The Canada Day Challenge 2017
Entry Form
IMPORTANT
• Complete and print the entry form.
Office, postmarked no later than March 31, 2017.
• Submit your entry along with your entry form to a
Canadian Heritage Regional
• You (or your parent or legal guardian if you are a minor in your province or territory of residence) are deemed to have read, understood and
accepted the 2017 Canada Day Challenge Official Rules.
If you have any questions about this form, send us an email at
PCH.defi-challenge.PCH@canada.ca
or visit our
website at
Part A - Participant Information
Participant's First Name (required)
Participant's Last Name (required)
Home Address (required)
City (required)
Province / Territory (required)
Postal Code (required)
Telephone Number (required)
Email Address (required)
Preferred language of correspondence? (required)
English
French
Part B - Entry Details
Category (required):
Age Group (required):
DRAW IT!
SNAP IT!
WRITE IT!
8 - 13
14 - 18
Please describe what inspired you to create your entry and how you learned about the Challenge (required):
If you made your entry as part of a class project (optional):
Name of your school
Your Grade
Telephone number of your school
Email address of your school
Part C - Consent Information
The undersigned participant, or his or her parent/legal guardian, hereby affirms that in consideration of being allowed to
participate, the entry is an original artwork.
Signature of Participant (if age of majority in your province/territory of residence):
Name of Parent or Legal Guardian (if participant is not of the age of
Signature of Parent or Legal Guardian
majority in his/her province/territory of residence)
Part D - Privacy Notice Statement
The collection and use of personal information for the Canada Day Challenge is authorized by sub. 4(1) of the Department of
Canadian Heritage Act and is in accordance with the Privacy Act. You can access your personal information by contacting our
Privacy Coordinator at
PCH.secretariatdelaiprp-atipsecretariat.PCH@canada.ca
Page 1 of 1
DCC-CCD-01F03_2016-10-06-eng

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go