Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Please let us know who is attending and the ages of any children!
Would Your Child like to Meet with Santa!
*
yes
no
Submit
Would you like to meet with Santa virtually or in-person?
in-person (12pm - 1:30pm)
virtual (1:30pm - 2pm)
Visit with Santa!
Please upload pix of your child(ren) here!
Browse Files
Drag and drop files here
Choose a file
Cancel
of
May we take a screenshot of your child's visit with Santa?
yes
no
Signature
Back
Next
How many children will participate?
Child #1
First Name
Last Name
Hearing Status
Please Select
Deaf
deaf
hard of hearing
hearing
Child uses ASL
yes
no
Age
Grade in School
Please Select
PreK
K
1
2
3
4
5
6
7
8
9
10
11
12
Name of School
Favorite Thing to Do
Naughty or Nice?
Please Select
naughty
nice
Accomplishment this year that he/she is proud of
Something you would like your child to work on (brushing teeth, making bed, cleaning kitchen, putting away toys, etc.)
Something your child wants for Christmas and is likely to receive
Child #2
First Name
Last Name
Hearing Status
Please Select
Deaf
deaf
hard of hearing
hearing
Child uses ASL
yes
no
Age
Grade in School
Please Select
PreK
K
1
2
3
4
5
6
7
8
9
10
11
12
Name of School
Favorite Thing to Do
Naughty or Nice?
Please Select
naughty
nice
Accomplishment this year that he/she is proud of
Something you would like your child to work on (brushing teeth, making bed, cleaning kitchen, putting away toys, etc.)
Something your child wants for Christmas and is likely to receive
Child #3
First Name
Last Name
Hearing Status
Please Select
Deaf
deaf
hard of hearing
hearing
Child uses ASL
yes
no
Age
Grade in School
Please Select
PreK
K
1
2
3
4
5
6
7
8
9
10
11
12
Name of School
Favorite Thing to Do
Naughty or Nice?
Please Select
naughty
nice
Accomplishment this year that he/she is proud of
Something you would like your child to work on (brushing teeth, making bed, cleaning kitchen, putting away toys, etc.)
Something your child wants for Christmas and is likely to receive
Child #4
First Name
Last Name
Hearing Status
Please Select
Deaf
deaf
hard of hearing
hearing
Child uses ASL
yes
no
Age
Grade in School
Please Select
PreK
K
1
2
3
4
5
6
7
8
9
10
11
12
Name of School
Favorite Thing to Do
Naughty or Nice?
Please Select
naughty
nice
Accomplishment this year that he/she is proud of
Something you would like your child to work on (brushing teeth, making bed, cleaning kitchen, putting away toys, etc.)
Something your child wants for Christmas and is likely to receive
Child #5
First Name
Last Name
Hearing Status
Please Select
Deaf
deaf
hard of hearing
hearing
Child uses ASL
yes
no
Age
Grade in School
Please Select
PreK
K
1
2
3
4
5
6
7
8
9
10
11
12
Name of School
Favorite Thing to Do
Naughty or Nice?
Please Select
naughty
nice
Accomplishment this year that he/she is proud of
Something you would like your child to work on (brushing teeth, making bed, cleaning kitchen, putting away toys, etc.)
Something your child wants for Christmas and is likely to receive
Submit
Should be Empty: