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2. To enter the Photo of the Month contest, fill in the boxes below and click the submit button.
4. Thanks for participating!
8. Your First Name
9. Your Last Name
11. Address1
12. Address2
14. City
15. State
16. Zip
18. Phone Number
20. Email Address
22. Location of photograph
23. Upload your picture*
24. Approximate date of photograph*
    Approximate date of photograph

    Approximate date of photograph
26. Title/caption of photograph*
28. Today's Date*
    Today's Date
30. Electronic Signature Agreement*

    I certify that I am the one who took this photograph. I understand that upon submission, this photograph, and all of the copy and trademark rights associated with the photograph, becomes the property of the City of Margate. I hereby grant permission to the City of Margate to use this photograph at their discretion with no compensation or credit to me, or to any subjects in the photograph. If the photograph includes identifiable people in a non-public place, I have obtained the permission of those in the photograph to submit this photograph for use by the City of Margate. I have read all of the attached rules and agree to them.

    1. I agree.
32. Electronic Signature*
34. If under 18 years of age, signature of parent or guardian *
36. The City of Margate is a public entity subject to Chapter 119 of the Florida Statutes concerning public records. Under Florida law, e-mail addresses are public records. The information you are providing is subject for release in response to a public records request. All e-mail messages sent and received are captured by our server and retained as public records.
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit Submit and Print

* indicates a required field