2023 Video Contest Submission Form

Complete the form below to enter your submission for the 2023 Video Contest. Please upload your video to YouTube or Vimeo (your own account) and you will be prompted to paste the direct link to the video at the end of the form below.

*For team videos, each student should complete a submission form signed by their respective parent/guardian.*

Student Name

Student Email Address

Student's Telephone Number

Address

City

State

Zip

High School/School Name

Teacher's Name
(If not applicable, enter "NA")

Grade
(If not applicable, enter "Home Study")

Team Name

Please list each student on your team
If this is a solo submission, enter NA

Parent/Guardian's Name

Parent/Guardian's Email Address

YouTube or Vimeo Link

I certify that I am the parent or guardian named herein, and that I understand that all video submissions provided to this competition become the property of the Vermont Jump$tart Coalition, which reserves the right to reproduce the video and publish the names of all student entrants, including winners. I certify that the entrant(s) are Vermont students enrolled in grades 7, 8, 9, 10, 11, or 12 of a school or technical career center, or grade 7, 8 9, 10, 11, or 12 students who are approved for home-school study as permitted by the rules of home study enrollment.

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