Clone of Diaper Giveaway 04.29.26

Adult First AND Last Name

Address

Phone Number

E-mail

Are you pregnant?

When is your due date?

Do you have a child that attends one of these programs?

ALL DIAPERS ARE FIRST COME, FIRST SERVE, WHILE SUPPLIES LAST.

Please list the name and DOB for children needing diapers.

Child 1 First AND Last Name

Date of Birth

Gender

What size diapers are you requesting for this child? NO PULL-UPS Available.

Child 2 First AND Last Name

Date of Birth

Gender

What size diapers are you requesting for this child? PULL-UPS Available.

Child 3 First AND Last Name

Date of Birth

Gender

What size diapers are you requesting for this child? PULL-UPS Available.

Child 4 First AND Last Name

Date of Birth

Gender

What size diapers are you requesting for this child? PULL-UPS Available.

Thank you for completing this form.

Registration does not guarantee that we have the requested size available. Limited diapers are available in each size.