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Winter Wonderland Application, 2023
Please fill out the form carefully for registration.
Head of Household
*
First Name
Middle Name
Last Name
Date of Birth
*
/
Month
/
Day
Year
MM-DD-YYYY
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Gender
*
Male
Female
Email:
*
Confirmation Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Children in Home (12 and under)
Fill out information for each child in your home
Number of people in your home:
Type number
1st child Age:
*
Boy or Girl?
*
Type Boy or Girl
Coat Size (please indicate if it is children's size or adult size):
Type Size
2nd child Age:
Boy or Girl?
Type Boy or Girl
Coat Size (please indicate if it is children's size or adult size):
Type Clothing Size
3rd child Age:
Boy or Girl?
Type Boy or Girl
Coat Size (please indicate if it is children's size or adult size):
Type Clothing Size
4th child Age:
Boy or Girl?
Type Boy or Girl
Coat Size (please indicate if it is children's size or adult size):
Type Clothing Size
5th child Age:
Boy or Girl?
Type Boy or Girl
Coat Size (please indicate if it is children's size or adult size):
Type Clothing Size
6th child Age:
Boy or Girl?
Type Boy or Girl
Coat Size (please indicate if it is children's size or adult size):
Type Clothing Size
Are you interested in donating blood for a 45.00 gift card?
Yes
No
Have you attended Winter Wonderland before?
*
Please Select
Yes
No
Are you interested in any flu or covid vaccinations?
Submit Application
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