Santa for Seniors Registration Form
Participants Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
Age (55+)
How did you hear about us?
*
Please Select
Facebook
Instagram
Newspaper
Website
Other
Participants Wish-List (ex. personal care items, gift cards, puzzles and books, clothing items, bedding, etc.)
If you have added clothing to the wishlist, what size, preferences would the participant like? (ex. small, medium large, favourite colour is green, prefers cotton, etc.)
Submit
Should be Empty: