: Sign-in

General Information
Full Name of Primary Parent/Guardian*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address AND Apartment Number (Winston-Salem area ONLY)*

Street Address

Apartment Number (If Needed)

CityState / Province

Postal / Zip Code
Please Select Your Annual Income Range*
We are no longer recieving applications for "Pick-Up". Sorry for any inconvience.
Where are you located?*

Piedmont CircleHutton St. ApartmentsSkyline (Timlic, Bruce St., Fitch St., etc.)Cleveland Homes (New Hope Lane, N. Cleveland Ave, E 15th & E17th, etc)Colony Place Apartments (Highland Ave, E 11th, N. Cleveland Ave)Rolling Hills (Ferrel Ct.)Salem Gardens Apartments (Salem Gardens Dr)Lakeside Villas (Walkertown Ave, East Dr. Lakeview Blvd, State St., Harrington Ct, Overlook Dr etc)
IF YOUR CLICKED "PICKUP": I understand that if I selected "PickUp" or live outside of City Light's Neighborhoods, I will come to pick up my Christmas gifts at a specified time/date/location.

I Understand

Child's Information
Child's Name*

First NameLast Name
Gender
Age as of December, 2023 (only ages 3-12)*
Clothing Size*
Shoe Size*
3-4 Gift Requests or Hobbies (NO BIKES, GIFT CARDS or ELECTRONICS)*
Reminder: if you plan on signing up more than one child, you have to fill out another form for each child you wish to sign up.

Thank you!
Should be Empty:

Check Off Each Box To Confirm You Understand Our Terms and Agreements.