2022 KidVid Submission Form
AUTHORITY: 22 USC 4024(c)(1)
     (c)Orientation and training for family members
     The Secretary may provide to family members of members of the Service or of
     employees of the Department or other agencies, in anticipation of their assignment
     abroad or while abroad
          (1) appropriate orientation and language training

PURPOSE: This collection of information is for administration of the KidVid Contest, which requires contact information for contestants and their parents.

ROUTINE USES:  This information is only used within the Department of State and not shared with external entities.  

DISCLOSURE: Providing this information is voluntary. However, failure to provide the information requested will result in ineligibility for the KidVid Contest.

I acknowledge that I have read, understand, and agree to the contest rules and uses for my video submission. This includes irrevocably granting the U.S. Department of State (“Department”) and the Foreign Service Youth Foundation (“FSYF”) permission to use the provided video of me and/or my dependent minors and to reproduce, release, publish, display, broadcast, and quote this material, in full or in part, as part of Department and FSYF public information programs and activities, including future speeches and press, in and on all manner of media whether now known or hereafter devised.

FSIOBCInfoCenter@state.gov
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Post: *
Child's First Name: *
Child's Last Name: *
Parent's First Name: *
Parent's Last Name: *
Child's Age: *
Parent's Agency: *
Parent's Work Email: *
Parent's Personal Email: *
The parent or legal guardian must submit this form. Please type your first and last name to sign and submit this form. *
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