Virtual Stuffed Animal Pageant Form

YWCA OF THE SAUK VALLEY'S STUFFED ANIMAL PAGEANT
Child's Name *
Child's school & grade *
What is your Stuffed animal's Name? *
So we know what to call him/her when they are in the pageant.
What type of animal is it? *
How did you and your friend unite? *
How long have you been together? *
What is special about your stuffed animal? *
What do you like to do together? *
Parent/guardian's Name: *
Address: *
Relationship to child: *
Home Phone:

Area Code Phone Number
Cell Phone:

Area Code Phone Number
E-mail:
example@example.com
Name of Emergency Contact:
Relationship to Emergency Contact:
Home Phone:

Area Code Phone Number
Cell Phone:

Area Code Phone Number
Release of Liability:

I hereby release the YWCA of the Sauk Valley from all liability related to my child’s participation in the Stuffed Animal Pageant.
Signature *

Clear
Activities/Publicity:

I give permission to the YWCA or any staff member to use any photograph, video, or story for publicity purposes in which the child’s first name or photograph is included.
Signature

Clear
Should be Empty:

YWCA OF THE SAUK VALLEY'S STUFFED ANIMAL PAGEANT