Adopt-a-Child

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Community Baptist Church 6114 Fifth St. Danbury, TX 77534 (979) 922-8491
Community Baptist Church is accepting applications for Christmas Adopt-a-Child. Our resources are limited and we will only be assisting with gifts for children ages: birth to 18, or through their high school senior year, and they must attend school in Danbury. All children must reside at the address given.
This form must be filled out completely and returned to us at 6114 Fifth St., Danbury or emailed to jessica.jennings6586@yahoo.com. Please provide proof of residence in Danbury.
Applications must be received no later than Monday December 1, 2025
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Parent's Name* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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Address* This field is required.
Street Address
Street Address Line 2
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Phone* This field is required.
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Alternate Phone Number
Please enter a valid phone number.
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Do you need assistance with food?* This field is required.
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How many ADULTS reside in the home?
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Have you applied for Christmas assistance anywhere else?
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If so, where did you apply?
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Have you received Christmas assistance from us in the past?* This field is required.
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How did you hear about our Adopta--Child program?
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Referrer's NameName of person completing this form (Referrer)?
First Name
Last Name
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Referrer's PhonePhone number of person completing this form (Referrer)?
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How many children are in the family?* This field is required.
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1
2
3
4
5
6
More than 6 (please fill out an additional form)
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Child 1 Information* This field is required.
Child's Name
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Boy
Girl
Gender
Age
Grade
Child's Interests
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XS
S
M
L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Shirt Size
Shoe Size
Pants Size (example - Child S, Child 6, Adult 10 petite, etc.)
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Child 2 Information* This field is required.Tell us information about the child
Child's Name
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Please Select
Boy
Girl
Gender
Age
Grade
Child's Interests
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Please Select
XS
S
M
L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Shirt Size
Shoe Size
Pants Size (example - Child S, Child 6, Adult 10 petite, etc.)
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Child 3 Information* This field is required.Tell us information about the child
Child's Name
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Please Select
Boy
Girl
Gender
Age
Grade
Child's Interests
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Please Select
XS
S
M
L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Shirt Size
Shoe Size
Pants Size (example - Child S, Child 6, Adult 10 petite, etc.)
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Child 4 Information* This field is required.Tell us information about the child
Child's Name
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Please Select
Boy
Girl
Gender
Age
Grade
Child's Interests
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XS
S
M
L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Shirt Size
Shoe Size
Pants Size (example - Child S, Child 6, Adult 10 petite, etc.)
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Child 5 Information* This field is required.Tell us information about the child
Child's Name
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Please Select
Boy
Girl
Gender
Age
Grade
Child's Interests
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Please Select
XS
S
M
L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Shirt Size
Shoe Size
Pants Size (example - Child S, Child 6, Adult 10 petite, etc.)
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Child 6 Information* This field is required.Tell us information about the child
Child's Name
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Please Select
Boy
Girl
Gender
Age
Grade
Child's Interests
Please Select
Please Select
XS
S
M
L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Shirt Size
Shoe Size
Pants Size (example - Child S, Child 6, Adult 10 petite, etc.)
Should be Empty: