Parent and/or Guardian Written Consent Form
Instructions: Parents and/or legal guardians please read this Parent Consent Form and the Contest Rules below carefully.
If you wish to give consent, please complete and sign the Parent Consent Form. The form can only be submitted via email to MelangeNola@gmail.com.
- The form can be printed and scanned to Melange.Nola.com
- You can also print the form and take a picture of the signature pages with your phone and email us if a scanner is not available.
Contest entries that are not accompanied by a properly signed and completed Parent Consent Form and any other necessary information or materials will not be accepted by Melange Nola, LLC. (Note: students who are 18 or older may complete and sign the consent form themselves.)
Full Name of Parent and/or Guardian
________________________________________________________I am the lawful legal parent and/or guardian of:
Child’s Full Name (the “Entrant”):
Date of Birth:
Place of Birth:
My signature below indicates that the Entrant has my consent and permission to items 1-6 below:
- Enter and participate in Melange Nola’s Homecoming Giveaway ( the “Contest”). I acknowledge that I have read and understand the attached Contest Rules, and that I and the Entrant will be bound by these Contest Rules.
- Allow the Entrant’s name, age, grade level, region, and school to be displayed along with their contest essay in Melange Nola, LLC’s print and digital publications.
- Participate in any media or promotional events, including any possible winner ceremonies, media interviews, and publicity events, related to the Contest.
- I confirm that the Entrant is a citizen or legal permanent resident of the United States and I will report any prize winnings to all relevant federal, state, and local tax authorities.
- Photo/Video Release: For good and valuable consideration, the receipt of which is hereby acknowledged, I, (Parent/Guardian), hereby authorize Melange Nola, LLC permission to use the Entrant’s likeness in photographs and video taken in relation to the Contest in any and all of its publications, including but not limited to all Melange Nola, LLC’s printed and digital publications. I understand and agree that any photograph or video using the Entrant’s likeness will become property of Melange Nola, LLC and will not be returned.
I acknowledge that since my participation with Melange Nola, LLC is voluntary, I will receive no financial compensation.
I hereby irrevocably authorize Melange Nola, LLC to edit, alter, copy, exhibit, publish or distribute the photos or video it takes related to the contest for the purpose of publicizing Melange Nola, LLC’s programs or any other related, lawful purpose. In addition, I hereby waive the right to inspect or approve the finished product, including written or electronic copy, wherein the Entrant’s likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photographs.
I hereby hold harmless and release and forever discharge Melage Nola, LLC from all claims, demands, and causes of action which I, my heirs, representatives, execuotors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.
- Privacy Disclaimer: Any personal information collected during the course of the Contest by Melange Nola, LLC will be used for administering this competition, or as otherwise set out in the Contest Rules. Except where prohibited by law, participation in the Contest constitutes the Entrant’s and his or her parent’s/legal guardian’s consent to the storage, use and disclosure of the Entrant’s entry details as set out in the Contest Rules.
Parent and/or Legal Guardian Contact Information
City, State, Zip:
Full Name and Signature of Parent and/or Legal Guardian: Date:
NO PURCHASE NECESSARY TO ENTER OR WIN. A PURCHASE WILL NOT INCREASE YOUR CHANCES OF WINNING. ALL FEDERAL, STATE, LOCAL, AND MUNICIPAL LAWS AND REGULATIONS APPLY. VOID WHERE PROHIBITED.
Melange Nola’s Homecoming Giveaway (the “Contest”) is open to legal residents of Louisiana that are a freshman, sophomore, junior, or senior at public or private Louisiana based secondary school. Employees of Melange Nola, LLC (“Melange”) and other companies associated with the promotion of the Contest, and their respective parents, subsidiaries, affiliates, and advertising and promotion agencies as well as the immediate family (spouse, parents, siblings, and children) and household members of each such employee are not eligible. The Contest is subject to federal, state, and local laws and regulations.
The Contest is sponsored by Melange located at 1032 Marvin Ct. Harvey, LA 70058.
- Agreement to Official Rules
Participation in the Contest constitutes Entrant’s full and unconditional agreement to and acceptance of these, Official Rules and the decision of the Sponsor, which are final and binding. Winning a prize is contingent upon being compliant with these Official Rules and fulfilling all other requirements set forth herein.
- Contest Period
The Contest begins on September 15, 2016 at 12:00AM EST and ends on October 21, 2016 at 11:59PM EST (the “Contest Period”). Entries that are submitted before or after the Contest Period will be disqualified. Submissions will be accepted for the duration of the Contest via email.
- How to Enter
Online: This method of entry will be available by visiting the Contest Page of our website (Melange-Nola.com) and following the directions provided.
- Follow @MelangeNola and @Rentachair on Instagram
- Melange Nola’s 2016 Homecoming Giveaway Flyer
- 4 Melange Nola IG Posts (Your Choice)
- Tag at Least One Friend in Each Repost
- Use the Hashtag #Melange When Reposting
- Submit a One Page Essay (Single or Double Spaced) on the following topic:
- “Who or what inspires you? Why?”
- Essays to be submitted on the Contest page of Melange-Nola.com
Note: Contest only open to students attending the participating high school (Chalmette High School).
Limit one (1) entry per person, per email address, and per household for the duration of the Contest Period, regardless of method of entry. Entries received from any person, e-mail address, or household in excess of the state limitation will be void. All entries become the property of the Sponsor and will not be acknowledged or returned.
- Prize Drawing
Due to the timing of the two homecomings, the Sponsor will select potential winners from among all eligible entries received throughout the contest period. The odds of being selected depends on the number of entries received and the quality of their essays. The Sponsor will attempt to notify the potential winner via telephone or email. If the potential winner cannot be contacted within twenty-four (24) hour after the first attempt to contact him/her, the Sponsor may select an alternate potential winner in his/her place from the remaining non-winning, eligible entries.
- Winner Notification
The potential winners will be notified by email or phone. Each potential Grand and secondary prize winner (parent/legal guardian if a minor in his/her state of residence) will be required to complete, electronically sign and submit a Declaration of Compliance within twenty-four (24) hours of the date notice or attempted notice is sent, in order to claim his/her prize. If a potential winner cannot be contacted or fails to submit the Declaration of Compliance within the required time period (if applicable), or prize is returned as undeliverable, the potential winner forfeits prize. If the potential winner is at least 18 but still considered a minor in his/her jurisdiction of residence, Sponsor reserves the right to award the prize in the name of his/her parent jurisdiction of residence, Sponsor reserves the right to award the prize in the name of his/her parent or legal guardian, who will be required to sign the Declaration of Compliance on the potential winner’s behalf and fulfill any other requirements imposed on winner set forth herein. Potential winners must continue to comply with all terms and conditions of the Official Rules, and willing is contingent upon fulfilling all requirements. In the event that a potential winner is disqualified for any reason, Sponsor will award the applicable prize to an alternate winner from among all remaining eligible entries. Only three (3) alternate drawings will be held, after which the prize will remain un-awarded. Prizes will be fulfilled approximately 4 weeks after conclusion of the Contest.
One Grand Prize winner from each school will receive:
- 3 Bundles of Melange Nola’s 100% Virgin Hair or 2 Packs of Melange Nola’s 100% Virgin Hair Clip-ins (including styling)*. Hair style, length, and type to be suggested by contest winner, but ultimately approved by Melange.
- Makeup Service for Your 2016 Homecoming Dance*
- A Melange Nola T-shirt
- 1 Year of Discounts on All Melange Nola Products
*Hair styling and makeup service will be done on the day of your homecoming dance. Our staff will gladly provide the service free of charge!
Runner Up Prize Winners
- The first three entrants from each school will receive 25% off their first hair purchase and a free installation with their purchase.
- All entrants receive 25% off their first purchase.
- General Conditions
In the event that the operation, security, or administration of the Contest is impaired in any way for any reason, including, but not limited to fraud, virus, bug, worm, unauthorized human intervention or other technical problem, or in the event the Contest is unable to run as planned for any other reason, as determined by Sponsor in its sole discretion, the Sponsor may, in its sole discretion, either (a) suspend the Contest to address the impairment and then resume the Contest in a manner that best conforms to the spirit of these Official Rules or (b) terminate the Contest and, in the event of termination, award the prize at random from among the eligible, non-suspect entries received up to the time of the impairment. The Sponsor reserves the right in its sole discretion to disqualify any individual it finds to be tampering with the entry process or the operation of the Contest or to be acting in violation of these Official Rules or in an unsportsmanlike or disruptive manner. Any attempt by any person to damage the website or undermine the legitimate operation of the Contest may be a violation of criminal and civil law, and, should such an attempt be made, the Sponsor reserves the right to seek damages (including attorney’s fees) and any other remedies from any such person to the fullest extent permitted by law. Failure by the Sponsor to enforce any provision of these Official Rules shall not constitute a waiver of that provision.
- Release of Limitations of Liability
By participating in the Contest, entrants agree to release and hold harmless the Sponsor, and each of their respective parents, subsidiaries, affiliates, advertising, and promotion agencies, other companies associated with the Contest, and each of their respective officers, directors, employees, shareholders, representatives, and agents (the Released Parties) from and against any claim or cause of action arising out of participation in the Contest or receipt or use of the prize (including any travel or activity related thereto), including, but not limited to: (a) any technical errors associated with the Contest, including lost, interrupted or unavailable Internet Service Provider (ISP), network, server, wireless service provider, or other connections, availability or accessibility or miscommunications or failed computer, satellite, telephone, cellular tower or cable transmissions, lines, or technical failure or jumbled, scrambled, delayed, or misdirected transmissions or computer hardware or software malfunctions, failures or difficulties; (b) unauthorized human intervention in the Contest; (c) mechanical, network, electronic, computer, human, printing, or typographical errors; (d) application downloads, (e) any other errors or problems in connection with the Contest, including, without limitation, errors that may occur in the administration of the Contest, the announcement of the winner, the cancellation or postponement of the event and/or the flyover, if applicable, the incorrect downloading of the application, the processing of entries application downloads or in any Contest-related materials; or (f) injury, death, losses or damages of any kind, to persons or property which may be caused, directly or indirectly, in whole or in part, from entrant's participation in the Contest or acceptance, receipt or misuse of the prize (including any travel or activity related thereto). Entrant further agrees that in any cause of action, the Released Parties liability will be limited to the cost of entering and participating in the Contest, and in no event shall the entrant be entitled to receive attorney’s fees. Released Parties are also not responsible for any incorrect or inaccurate information, whether caused by site users, tampering, hacking, or by any equipment or programming associated with or utilized in the Contest. Entrant waives the right to claim any damages whatsoever, including, but not limited to, punitive, consequential, direct, or indirect damages.
Except where prohibited, each entrant agrees that any and all disputes, claims and causes of action arising out of, or connected with, the Contest or any prize awarded shall be resolved individually, without resort to any form of class action, and exclusively by the appropriate court located in Louisiana. All issues and questions concerning the construction, validity, interpretation and enforceability of these Official Rules, entrants’ rights and obligations, or the rights and obligations of the Sponsor in connection with the Contest, shall be governed by, and constructed in accordance with, the laws of Louisiana, without giving effect to any choice of law or conflict of law rules, which would cause the application of the laws of any jurisdiction other than Louisiana.