2025 Shopping Experience Registration

Shopping Experience Registration
Attended?

YesNo
Number of Children
Enter the number of children
1) Child's Name*

First NameLast Name
Age*
Gender*

BoyGirl
2) Child's Name

First NameLast Name
Age
Gender

BoyGirl
3) Child's Name

First NameLast Name
Age
Gender

BoyGirl
4) Child's Name

First NameLast Name
Age
Gender

BoyGirl
5) Child's Name

First NameLast Name
Age
Gender

BoyGirl
Parent/Guardian*

First NameLast Name
Address*

Street Address

Street Address 2

City (Marion County, Lakeview, Latta, Fork Only)State

Zip Code
Email
example@example.com
Mobile for Texting*

Area CodePhone Number
Phone Number

Area CodePhone Number
I understand and agree that donated items received will not be sold to others and have not registered with another organization to receive toys for the children registered on this form.
Organizational Approval Code
Official Use Only
Should be Empty: