Back to School Bash Registration Form

A.N.A.'s Friends Back to School Bash - 2024
Get ready for an unforgettable experience! This event provides foster children with a backpack filled with school supplies, a gift card for brand-new clothes, and a thrilling night out at a Mighty Mussels game – a memory they'll cherish forever! The fun doesn't stop there – LCSO’s Ice Cream Response Team and the amazing Way Too Tall Torrie will be on hand, with bounce houses, games, and more available to enjoy. You won’t want to miss it!

Plus, backpacks and supplies will also be available for other children in the home, and game tickets and concession vouchers will be provided for the whole family!

Thank you to our sponsors and partners!

Date:

Saturday, August 3rd, 2024
Backpack Distribution - 4:30 - 6:00 pm
Game Start - 6:00 pm

Address:

Lee Health Sports Complex
14100 6 Mile Cypress Pkwy
Fort Myers, FL 33912
Person Filling Out Form*

First NameLast Name
Your address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Phone Number*
Please enter a valid phone number.
Your Email address*
example@example.com
Connection to the Foster Child*

GAL Office - Staff or Guardian ad Litem VolunteerCase ManagerJudgeOther - please specify below
Other Connection
I confirm that I am registering a child/children who currently has an active dependency court case in Lee, Charlotte, Collier, Hendry, or Glades County. I understand that providing false information is considered fraud and will be subject to investigation.

Powered by Jotform SignClear
Foster Placement Contact Full Name*

First NameLast Name
Foster Placement Contact E-mail*
example@example.com
Foster Placement Contact Phone Number*
Foster Placement Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Foster Child's Full Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Date
Do you have another foster child/children in this home you wish to register?

YesNo
Foster Child's Full Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
Foster Child's Full Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
Foster Child's Full Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
County with Legal Jurisdiction *
Date Child/Children Was/Were Placed in the Home*

MonthDayYear
Date
Number of other children (non-foster) in the home needing school supplies?
Backpacks and school supplies will be distributed on a FIRST COME FIRST SERVED basis. Child does not need to reside in Lee/Collier/Charlotte Hendry or Glades County.
A.N.A.'s Friends is thrilled to offer an exciting night at the ballpark for the famlies we serve! We will provide free parking, game tickets, and meal vouchers for all family members staying to enjoy the game.
Will the the child/family be staying for the baseball game at 6 pm?*

YesNo
If staying, how many game tickets and meals will be needed for the family?
Are additional tickets needed for anyone else (for example a Guardian ad Litem Volunteer who plans to stay for the game)?*

YesNo
If so how many game tickets and meals will be needed for these guests?
Comments or questions?
Should be Empty:

A.N.A.'s Friends Back to School Bash - 2024