KY Youth Storytelling
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Kentucky Youth Storytelling
Entry & Permission Form
If you are entering through a mailed DVD, your signed permission form and your DVD must be postmarked or hand delivered by midnight June 1st.
If you are submitting via electronic video link, your signed permission form must be postmarked or hand delivered by Midnight June 1st.
Please provide the link to your online video here
TIP: Make sure your link works. Test it!
Please tell us anything we need to know in order to be able to judge your
For example: Are you a teller who is deaf? Are you a teller who is blind? Are you a teller
with limited mobility? Was your first language a language other than English? Are you a teller with a
speech impediment? Other information we need to consider?
We welcome all kinds of stories. Please tell us about the story youíve chosen.
I wrote this story.
I heard this story.
Who told it and what is your relationship to them?
I have permission to tell this story from the person who told it.
I cannot secure permission from the person who told the story because they are no longer living.
I cannot secure permission for another reason. Please explain.
This story is a public domain story or a story with no copyright.
This story is a tale I have retold based on several sources. List the sources.
This story was written by a particular author. List author, title, publisher, and date of publication.
I tell this story using the authorís exact words.
I have adapted/changed the authorís work for storytelling. Describe your adaptations/changes.
I have permission to tell this story from the author or authorís publisher.
Other/additional information needed to help KSA understand the source of this story. Please explain.
Check the following boxes to indicate compliance.
I hereby give my permission for my child/ward (type childís full name in box, please) to compete in the Kentucky Youth Storytelling.
I hereby give permission for my child's photograph, bio, hometown, and state to appear on the Kentucky Storytelling Association (KSA) website. Street addresses and phone numbers would not be publicly posted at any time.
I understand that excerpts from my child's video entry may be used to promote the Kentucky Storytelling Association and the Kentucky Youth Storytelling Program.
I understand that performances presented on behalf of KSA may be taped (video or audio) or photographed and that the recordings and photos may be used for promotional purposes by KSA.
Required Ė Signature of Storyteller and Parent/Guardian
Storyteller Signature ___________________________ Date ___________
Parent/Guardian Signature _______________________Date ___________
Mail this signed Entry & Permission Form to:
The Kentucky Storytelling Association is not responsible for lost, stolen, late delivered, or undelivered entries or entries that will not play on standard home DVD or computer equipment.
Please check that the above information is correct.
NOTE: Please print two copies of this completed form using your web browser's print button (which usually looks like a printer) BEFORE YOU CLICK ON THE SUBMIT BUTTON BELOW. You will need a copy for your entry and a copy for your records.