Kid of the Month Entry Form

(Please fill out completely)

To nominate a Radio Disney Kid of the Month:

  • Print out this page and fill out the entire form. If you don't have a printer, write the information on a separate piece of paper (please print).
  • VERY IMPORTANT: Please read the rules.
  • Mail your form to:
Radio Disney Kid of the Month Contest
P.O. Box 802626
Dallas, TX 75380

Winning nominees (ages 14 and under) will be those whose deeds both enhance and show the goodness of the child's character by making a contribution to education, family, community, and/or environment. Judges will look for demonstrated initiative of the child that is above and beyond the expected. 

Name of Nominee:_____________________________________________
                  LAST                FIRST

Name of Parent/
Legal Guardian: _____________________________________________
                  LAST                FIRST                     


Address: ____________________________________________________


         ____________________________________________________
            STREET ADDRESS                       APT. #


City:________________  State:__________  Zip code:___________

                              Parent/Legal
                              Guardian's
Home Phone:__________________ Daytime Phone:_________________
           (AREA                             (AREA
            CODE)                             CODE)
			 

Age of Nominee:_____ Birthdate of Nominee:_____/______/______
                                          MONTH  DATE   YEAR

 


Description of Deed:(50 words or less)

_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________
No purchase necessary. Void where prohibited. Kids 14 and under are eligible to be nominated as Radio Disney's Kid of the Month, a monthly feature recognizing a child as a hero for putting forth an extra effort. Child selected as Kid of the Month will win a "Kid of the Month" trophy and a prize as announced on-air. Anyone can nominate a child for the contest. A child may not nominate him/herself. Entries must be submitted ONLY via mail to Radio Disney Kid of the Month Contest, P.O. Box 802626, Dallas, TX 75380. Valid entries must be legibly written in pen or typed on a postcard or 8.5" x 11" piece of paper and include all of the following information: a description of the deed performed (IN 50 WORDS OR LESS), the first and last name, and area code and phone number of the child who performed the deed, plus his/her address, city, state, zip code, and age. The entry must also contain the first and last name of the nominating person, his/her day and nighttime phone number(s) with area code, and relationship/connection to the nominated child. Only children who are 14 years of age or under at time of nomination and legal residents of the continental United States, Hawaii, and Alaska are eligible to win Kid of the Month. No one who is nominated or who is nominating another person can be an employee of Radio Disney, ABC Radio Networks, ABC, Inc., affiliates of Radio Disney, Disney Enterprises, Inc., and its subsidiary companies, their corporate licensees, affiliated advertising agencies, or participating sponsors/promotional partners, or be a member of the immediate family of anyone so employed. Deed must have been performed by the child within the last 12 months. If this deed is not verified by parent/guardian and nominated child to the satisfaction of Radio Disney, the entry will be disqualified. Kid of the Month will receive a total prize package with approximate retail value of $800 - $1,500 to be announced on-air. Some restrictions may apply. Payment of all federal, state, and local taxes is the sole responsibilit of the winner. To obtain a copy of the rules, send a self-addressed stamped envelope to Radio Disney Kid of the Month Rules, P.O. Box 802626, Dallas, TX 75380. To obtain a list of Kid of the Month Winners over the past 12 months, send a self-addressed stamped envelope to Radio Disney Kid of the Month Winners' List, P.O. Box 802626, Dallas, TX 75380. 
 

Nominated By: _______________________________________________
    (NAME)     LAST                FIRST      


Address: ____________________________________________________
             STREET ADDRESS                       APT. #

         ____________________________________________________
             CITY              STATE            ZIP CODE


Home Phone:__________________ Daytime Phone:_________________
           (AREA                             (AREA
            CODE)                             CODE)
			 

Your Relationship to Nominee:________________________________
                            (PARENT, GUARDIAN, RELATIVE, 
                             TEACHER, FRIEND, SIBLING, OTHER)


Your Signature: _____________________________________________
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