CBS4's Project Homefront
(Either print this form, or copy and paste the questions into your email browser and send to firstname.lastname@example.org )
Personal Contact Information
[If minor: Parent/Guardian Name]
Home and Cell Number:
Relationship to Family:
Family's Contact Information
Home or Cell Number:
Family Description: (use as much or as little space as you need).
All submissions must come from within the CBS4 viewing area in order to be considered.
If entry is submitted by a minor (under 18) parental/guardian consent must be provided in writing.
All decisions announced by CBS4 are final.
No purchase or donation is required to participate.
CBS4 and its sponsors may use families and nominators' likeness without compensation and any materials/video collected during the run of the campaign for news/promotional purposes. Winners must agree to participate in on-air story.
CBS4, its sponsors and its employees, participating agencies, and/or organizations and their employees are released from any and all claims that may arise.
CBS4, its sponsors and its employees, participating agencies, other media groups/stations and their families are not eligible to participate.
Winners will be notified upon winning how and when the prize will be distributed.
No transfer or substitution of winnings is permitted.
CBS4 management reserves the right to establish additional or change existing rules.
In case of circumstances beyond our control, CBS4 reserves the right to postpone or cancel the campaign.
The form may be submitted by email (attach this word doc) OR U.S. mail to the address listed below.
Mail to: Email to:
231 18th Street
Attn: Project Homefront
Rock Island, IL 61201
Parent/Guardian Signature Date