Holiday Gifts for Kids Bemidji
2024 Registration Form
Parent(s)/Legal Guardian(s)
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Physical Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
*Email is required in order to receive a confirmation notice. If you do not see an email confirmation by Dec. 11th, please check your junk folder. If you do not have an email address, please put NA and call United Way of Bemidji Area at 218-444-8929 to make other arrangements.
FIRST & LAST NAME OF EACH CHILD YOU ARE THE PARENT / LEGAL GUARDIAN OF, NO NOT LIST NICKNAMES. Only one gift per child is permitted. Do not fill out additional forms or have anyone else complete forms for any child you have listed.
Child's First & Last name
Age(0-17 only)
Date of Birth
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
*Disclaimer: If a child's name is listed on more than one registration form, we will contact you to determine legal guardianship.
I have read and agree to the Important Information form that goes with this application (view and download the "Important Information" document at www.unitedwaybemidji.org/holiday-gifts-kids). I affirm that all information completed on this form is accurate. I affirm that I am the parent or legal guardian to all the children listed above and they all live at the above address and are residents of Beltrami, Hubbard or Clearwater counties. I understand, I will receive a confirmation email allowing me to participate in the 2024 Holiday Gifts for Kids program. If my application sis not approved, I understand I will receive a regret notice by email.
Click below to indicate all the information provided is correct and that you understand the disclaimers above.
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I understand
Submit
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