EEYP Poetry Contest Submissions

About Expose Excellence Youth Program

Mission: To provide a safe environment for youth interaction while promoting positive self- expression and development of life skills and artistic expression.

Expose Excellence Youth Program is accepting submissions for the 2025 Black History Month Poetry Contest.

The top 3 finalists will recite their poems and be awarded at the 4th annual Exposing Black Artistry event on February 15th.

Fort Bend County youth may submit an original poem only using the form below and following the guidelines below.
- Registrant must be ages 10-17
- Must reside in Fort Bend County
- Must be enrolled in a school within Fort Bend County or homeschooled
- Must submit by deadline using this submission form
- Emailed submissions will not be accepted
- Must be available 2/15 to recite poem if selected as a finalist
- Submissions with profanity or inappropriate content will be disqualified
The contest will close on Friday, February 7th at 8:00am

If you have any questions, please contact the EEYP Coordinators: raven.forrester@fortbendcountytx.gov or wendi.palomera@fortbendcountytx.gov
Student Name*

First NameLast Name
Student Age
Student Email*
You will be contacted via email if you are a finalist!
Zip Code*
School*
Must be a school within Fort Bend County or homeschooled
Grade*
PROMPT: Hidden Figures in Black History

·What fun facts do you know about Black History Month?

·What is something you did not learn in school regarding Black History?

·Who are lesser-known historic figures in Black History?

Please type or copy & paste your submission below.
Enter written submission below. *
Are you available to attend the event on Saturday, February 15th if you are selected as a finalist?*

YesNo
Parent/ Guardian 1*

First NameLast Name
Parent/Guardian Email Address*
Parents will receive a confirmation email and may be contacted to confirm attendance.
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian 2

First NameLast Name
Parent/Guardian 2 Email Address
Parents will receive a confirmation email and may be contacted to confirm attendance.
Parent/Guardian 2 Phone Number
Please enter a valid phone number.
Background Information
The information below is collected for reporting purposes and is kept completely confidential. This is to ensure the safety of the participants and the awareness of program coordinators.

This information will not be used for the contest criteria.
Race (select all that apply)

Hispanic or LatinxAfrican American or BlackAsian American or Pacific IslanderNative American or American IndianCaucasian or WhiteOther
Primary Language In Home

EnglishSpanishOther
Select All That May Apply

ADD/ADHDAsthmaDiabetes(Typpe1/Type2)Learning Disabilities or Developmental DelaysNone/ N/AOther
Dietary Restrictions & General Allergies
Type N/A if not applicable
Medications Taken By Participant
Type N/A if not applicable
Please review the standard terms & conditions for participation in Expose Excellence Youth Program events and activities:

Permission to Obtain Medical Care

I authorize Expose Excellence Youth Program to obtain medical care for my child in the case of a medical emergency. I understand that I am financially responsible for the care given. Medical treatment includes transportation for the child by emergency vehicle to an appropriate health care facility and pre-hospital medical care, all hospital and physician services, whether medical, surgical and/or dental, necessary for the benefit/safety/well being of the student.

Media Release

I grant permission for my child to be photographed and/or videotaped during the event, and for the images, my child's name, and/or recordings to be published, reproduced, or distributed by Expose Excellence Youth Program and its affiliates, without financial remuneration to me, in all outlets, including, but not limited to, television, newspapers, internet, Expose Excellence Youth Program publications, recruitment materials, and ads without liability or limitation on me.

Liability Waiver

I agree to allow my child to participate in Expose Excellence Youth Program. As consideration for participation in these activities, I hereby agree that Expose Excellence and their respective employees, agents or contractors ("protected parties") shall have no liability for any claims, actions, demands, losses, costs, expenses, penalties, injuries, and/or damages of any kind arising out of or related to the program activities, even if such claims arise out of negligent, grossly negligent, reckless, or willful acts of the protected parties. I therefore waive any and all such claims that I and/or the child may have against the protected parties.

Disclosure of Information

Participants in Expose Excellence Youth Program have the right to confidentiality and privacy. Fort Bend County Expose Excellence Youth Program will not share any of your personal information unless you give us written permission to do so.

I agree to abide by said policies and to cooperate with staff to ensure my compliance with Fort Bend County Expose Excellence Youth Program policies and acknowledge that I have read, understood, and agree to the above waiver of liability.
Parent Signature*

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