: 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*
Where are you located?*

Piedmont CircleHutton St. ApartmentsSkyline (Timlic, Bruce St., Fitch St., etc.)Colony Place Apartments (Highland Ave, E 11th, N. Cleveland Ave)Rolling Hills (Ferrel Ct.)Salem Gardens Apartments (Salem Gardens Dr)Pick-Up
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
Child's Age*
Child's Birthday*

MonthDayYear
Date
Clothing Size ((Specify Toddler, Youth or Adult Size)*
Shoe Size (Specify Children, Youth or Adult Size)*
3-4 Gift Requests or Hobbies (NO BIKES, GIFT CARDS or ELECTRONICS)*
Are You Signing Up One Child Or Multiple?*

I am only signing up one childI am signing up multiple children
Reminder: if you plan on signing up more than one child, you have to click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!

Child #2 Information
Child's Name

First NameLast Name
Gender
Child's Birthday

MonthDayYear
Date
Child's Age
Clothing Size (Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Children, Youth or Adult 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 click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!

Child #3 Information
Child's Name

First NameLast Name
Gender
Child's Age
Child's Birthday

MonthDayYear
Date
Clothing Size (Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Toddler, Youth or Adult 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 click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!

Child #4 Information
Child's Name

First NameLast Name
Gender
Child's Birthday

MonthDayYear
Date
Child's Age
Clothing Size (Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Children, Youth or Adult 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 click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!

Child #5 Information
Child's Name

First NameLast Name
Gender
Child's Birthday

MonthDayYear
Date
Child's Age
Clothing Size (Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Children, Youth or Adult 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 click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!

Child #6 Information
Child's Name

First NameLast Name
Gender
Child's Birthday

MonthDayYear
Date
Child's Age
Clothing Size (Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Children, Youth or Adult 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 click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!
Should be Empty:

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