SOLA’s

3^RD Annual Dixie Kane Memorial Contest

Contest Entry, Agreement, and Release Form

Please print

Name:________________________________________________________________

Address:______________________________________________________________

City: _______________________________State:_________ Zip Code_____________

Telephone:_____________________________________________________________

Email:_________________________________________________________________

Entry Title:_____________________________________________________________

Estimated Word Count of completed novel:___________________________________

Category:

1^st choice_____________________________________________________________

2^nd choice_____________________________________________________________

Targeted Publisher: _____________________________________________________

Tell us how you heard about the Dixie Kane Contest ___________________________

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The Dixie Kane Memorial Contestant's Entry, Agreement, and Release

By my signature, I understand and agree to accept and abide by the decisions of contest officials and judges. I also accept and realize that manuscript judging is subjective by nature and shall hold harmless The Southern Louisiana Chapter of the Romance Writers of America, Inc., its contest officials and judges, should any dispute arise from my participation in The Dixie Kane Memorial Contest. I swear my work entered in this contest is original and not accepted for publication at the time of entry. I realize that participation does not guarantee publication of my manuscript. I further realize that my contest entry would not be accepted if I do not show my acceptance of the Contestant's Agreement and Release by my signature below.

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Signature Date

3RD Annual Dixie Kane Memorial Contest

Contest Entry, Agreement, and Release Form

3^RD Annual Dixie Kane Memorial Contest