Santa Home Visit (Not Christmas Eve)
Information collected on this form is only to be used for the purpose of talking to the child during a home visit with the parent/guardian present . All information will be destroyed after the home visit has been completed. Parent/Guardian email address will be collected for future emails from Warrenton Santa. Email subscription permission - Option to opt-in or out is at the bottom of the form.
Parent Name
*
First Name
Last Name
Parent Email
*
example@example.com
Address of the Visit
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent Phone Number
*
-
Area Code
Phone Number
I understand that the appointment agreed upon is what I have agreed upon with Santa verbally. I understand that Santa will contact me in the event of a scheduling conflict for the same.
*
Yes
Requested Date
*
-
Month
-
Day
Year
Date
Requested Time
*
I understand that this is a retainer for services provided. Any refund is at the sole discretion of Santa.
*
Yes
Name of Child #1 participating
*
First Name
Last Name
Name of Child #2 participating
First Name
Last Name
Name of Child #3 participating
First Name
Last Name
Name of Child #4 participating
First Name
Last Name
Name of Child #5 participating
First Name
Last Name
Type of School Child #1 participating
*
Preschool
Homeschooling
Public
Online
Elementary
Middle School
High School
College
Type of School Child #2 participating
Preschool
Homeschooling
Public
Online
Elementary
Middle School
High School
College
Type of School Child #3 participating
Preschool
Homeschooling
Public
Online
Elementary
Middle School
High School
College
Type of School Child #4 participating
Preschool
Homeschooling
Public
Online
Elementary
Middle School
High School
College
Type of School Child #5 participating
Preschool
Homeschooling
Public
Online
Elementary
Middle School
High School
College
Do you desire Santa to discuss the Birth of Jesus?
*
Yes
No
Brief History of this year's accomplishments - Please break apart per child
*
Do you wish to receive future emails that will include information and discounts from Warrenton Santa?
*
Yes
No
My Products
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Home visit with Santa
Home visit with Santa (Up to 4 Nice Certificates are included). Children check their name in the "Nice Book." Talk about Santa's Reindeer. - 30 minutes
$
75.00
Additional Child
$
4.00
Submit
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