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    Youth Recognition Registration Form

    This form is for all students grades K - 11 who were honored at school or by the community for noteworthy accomplishments (i.e. stellar academic performance, perfect attendance, Do the Right Thing or any other outstanding character or community service award.) Registration deadline is June 22.

    Student's First Name (required)

    Student's Last Name (required)

    Parent's/Guardian's Name (required)

    Contact Email (required)

    Your Phone (required)

    Grade student last completed (required)

    School (required)

    List academic or community service accomplishments


    We at the Greater Providence Baptist Church collect individual and group photos and testimonials relating to our volunteers, supporters and activities. We use these photographs, videos, profiles and stories for various purposes, such as promotional, advertising, commercial, educational, research and archival purposes. I agree that the Greater Providence Baptist Church may use any image, photograph, voice or likeness, in its promotional materials and publicity efforts without additional compensation. I understand that these photographs, images, video or audio may be retouched or enhanced and may further be used in publications, print ads, electronic media (e.g., video, CD-ROM, Internet/WWW), or other media now known or hereafter created, anywhere in the world. I further understand that by participating in the photography or filming, I release the Greater Providence Baptist Church and its representatives, licensees, employees, photographers, and their designees from any and all liability for any violation of any privacy or proprietary rights.

    I accept the terms above. (Form cannot be submitted without acceptance of terms.)