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 photo to be posted on websites and social media sites.

 

* Legal Parent or Guardian’s Electronic Signature
(Required)

* Date

STEP 1. Hit the submit button below so we have your submission form.

STEP 2. After submitting your form, you will then be asked to upload your child's photo. Before uploading, please be sure the file name of your photo matches your child's name. EXAMPLE: joe.phillips.jpg

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