Juneteenth Teen Poetry Slam Event Registration

Thank you for your interest in competing in Save Rochester's 3rd Annual Juneteenth Teen Poetry Slam. Please fill out this short survey to complete your registration.


3rd Annual Juneteenth Poetry Slam
Highland Bowl
South Avenue
June 18th, 2021 at 11 am

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* 1. Will you be at least 13 years of age and no older than 19 years of age on June 18th, 2022?

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* 2. Date of Birth

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* 3. Do you or will you have an original piece of poetry, not copied or plagiarized from any other source, to perform for the competition?

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* 4. Your poem MUST relate to Black History, Juneteenth, or any other Black Lives Matter issue. Will you perform an original poem pertaining to one or more of these issues?

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* 5. How would you like to receive additional information about Save Rochester's 3rd Annual Juneteenth Teen Poetry Slam?

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* 6. First and Last Name

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* 7. Your Email Address

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* 8. Your Phone Number

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* 9. Parent or Guardian Phone Number

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* 10. There is a one time $10.00 registration fee to ensure your commitment and participation in our program.

You can pay your registration fee via Cashapp, Venmo, or PayPal (credit card required). If you prefer to pay in person, please call 585-667-0660

Cashapp: $saverochester
Venmo: @saverochester
Paypal available at SaveRochester.org 

The registration fee is non-refundable. Do you understand that you will not be registered for the competition until your registration fee is paid in full and should you not attend the event you will forfeit your registration fee?

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