Oral Health Photo Contest
Oral Health Photo Contest Header Image
"Share Your Smile with Alabama"
Photo Contest Submission Form

Note: This contest is for children attending third grade in Alabama only. Be sure you have read the Official Contest Rules before submitting your photo.

* Student's Name

* Student's Birthdate

* Name of School

* Name of Homeroom Teacher

* Name(s) of Parents

* Parent's Email Address

* Parent's Phone Number(s)

By signing below, I verify that the photo submitted is the work of my own creation and that all individuals who appear in the photo have given their permission for the video to be posted on websites and social media sites.


* Legal Parent or Guardian’s Electronic Signature

* Date

To submit your photo, click here: https://www.dropbox.com/request/qf9dVqmyT82XpCDH6zbT. Be sure the file name matches your child's name. Ex: joe.phillips.jpg

We will notify all entrants by phone or email once the winning photos are selected.

Please be sure to hit the submit button below so we have your submission form.