Crimson Action Challenge - Entry Form

Please complete the form below and upload the same photos or video you shared on Facebook or Instagram. Thank you for participating in the Paint the Country Crimson Contest and helping us raise awareness about sudden cardiac arrest in kids!

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1. Who are you entering on behalf of? (Required.)

Myself

My family

School

Team

Business

Organization

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2. If individual or family: Full Name

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3. If School, Team, Business, or Organization, enter complete name.

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4. Primary contact person’s full name, if applicable.

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5. Email Address (Required.)

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6. Mobile Number (Required.)

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7. City and State (Required.)

City

State

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8. Tell us about your Crimson in Action activity. What did you do and who did you reach. (Required.)

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9. Which area(s) of Crimson for Kids did your activity support? (Required.)

Awareness

Education

Prevention

Readiness

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10. Approximately how many people did you reach? (Required.)

Please upload your photos or video. Use the link below to upload your Crimson in Action Challenge photos or video to Egnyte, our cloud server. Use the same name entered on this form so we can match your submission.

Link to upload: https://parentheartwatch.egnyte.com/ul/5bgbko1GFV

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11. Where did you share your Crimson in Action Challenge entry? (Required.)

Facebook

Instagram

Both

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12. CERTIFICATION AND PERMISSION (Required.)

I certify that the information submitted in this entry is accurate and that I have permission to submit the photos and/or video included with this entry. If minors appear in the submitted content, I confirm that I am their parent or legal guardian or have obtained permission from their parent or legal guardian. I give Parent Heart Watch permission to use, reproduce and share the submitted photos, video and entry information for purposes related to the Crimson for Kids campaign, including its website, social media, email communications and other promotional materials.

Crimson Action Challenge - Entry Form

Question Title

* 1. Who are you entering on behalf of? (Required.)

Question Title

* 2. If individual or family: Full Name

Question Title

* 3. If School, Team, Business, or Organization, enter complete name.

Question Title

* 4. Primary contact person’s full name, if applicable.

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* 5. Email Address (Required.)

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* 6. Mobile Number (Required.)

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* 7. City and State (Required.)

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* 8. Tell us about your Crimson in Action activity. What did you do and who did you reach. (Required.)

Question Title

* 9. Which area(s) of Crimson for Kids did your activity support? (Required.)

Question Title

* 10. Approximately how many people did you reach? (Required.)

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* 11. Where did you share your Crimson in Action Challenge entry? (Required.)

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* 12. CERTIFICATION AND PERMISSION (Required.)

1. Who are you entering on behalf of? (Required.)

2. If individual or family: Full Name

3. If School, Team, Business, or Organization, enter complete name.

4. Primary contact person’s full name, if applicable.

5. Email Address (Required.)

6. Mobile Number (Required.)

7. City and State (Required.)

8. Tell us about your Crimson in Action activity. What did you do and who did you reach. (Required.)

9. Which area(s) of Crimson for Kids did your activity support? (Required.)

10. Approximately how many people did you reach? (Required.)

11. Where did you share your Crimson in Action Challenge entry? (Required.)

12. CERTIFICATION AND PERMISSION (Required.)