After you have uploaded your video to YouTube and completed Step 1, return to this page and fill out this form.

YouTube URL (Paste your YouTube link in this field):

Video Title:

Video Category:
Cover the Cough
Physical Activity / Obesity
Distracted Driving

Team Captain's Name:
     

Team Captain's Email:

Team members' names, one per line:

Age Group:
Middle School
High School
Open Category

Name of School:

Teacher's Name:
     

Teacher's Email:

Before you click Submit, please read the rules of the contest. When you submit your entry, you agree to the rule and conditions of the context. If you are under 18 years, you should discuss with your parent or teacher before you submit your entry.

Even if you submit your entry online, your entry is not complete until you submit the entry form signed by a legal guardian, and the video release form.

Forms can be be faxed to (937) 645-3047 or mailed to:

PSA Contest
C/O Union County Health Department
940 London Ave, Suite 1100
Marysville, Ohio 43040