Kids Media Submission Form
Submit your child's creative work for consideration and possible publication. Please complete all required fields and provide parental consent.
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child's First Name
*
Child's Age
*
Type of Media
*
Photo
Video
Artwork
Story/Writing
Other
Title of Submission
*
Description of the Media (Please describe the content and context)
*
Upload Media File
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
I confirm that this submission is the original work of my child and that I am the legal parent or guardian with the authority to give permission for its use.
*
Yes, I confirm and give permission for my child's media to be used, published, or displayed by the organization.
Signature of Parent/Guardian
*
Date of Submission
*
-
Month
-
Day
Year
Date
Additional Comments or Information (optional)
Submit Media
Submit Media
Should be Empty: