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Safety Town Mascot Sweepstakes Entry Form

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Name*

Address*

City, State*

Zip*

Telephone*

E-Mail Address*

Date Of Birth*


I understand that the work entered must be original, must be that of a child 6 to 10 years old and that only a child's parent or legal guardian 18 or older may submit the entry. (Answer Required)


Are you a parent or legal guardian of the child whose original work you are submitting? (Answer Required)


Is the child whose original work you are submitting 6 to 10 years old? (Answer Required)


Submit a photo of your child's original drawing of a proposed Town of Brookhaven Safety Town Mascot.*

(Allowed File Types:jpg, gif, png)


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