Clone of Christmas Sign Up 2026

General Information
Full Name of Primary Parent/Guardian

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address AND Apartment Number (Winston-Salem area ONLY)

Street Address

Apartment Number (If Needed)

CityState / Province

Postal / Zip Code
Please Select Your Annual Income Range
Where are you located?
IF YOUR CLICKED "PICKUP": I understand that if I selected "PickUp" or live outside of City Light's Neighborhoods, I will come to pick up my Christmas gifts at a specified time/date/location.

Child's Information
Child's Name

First NameLast Name
Gender
Child's Age
Child's Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Clothing Size ((Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Children, Youth or Adult Size)
3-4 Gift Requests or Hobbies (NO BIKES, GIFT CARDS or ELECTRONICS)
Are You Signing Up One Child Or Multiple?
Reminder: if you plan on signing up more than one child, you have to click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!

Child #2 Information
Child's Name

First NameLast Name
Gender
Child's Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child's Age
Clothing Size (Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Children, Youth or Adult Size)
3-4 Gift Requests or Hobbies (NO BIKES, GIFT CARDS or ELECTRONICS)
Reminder: if you plan on signing up more than one child, you have to click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!

Child #3 Information
Child's Name

First NameLast Name
Gender
Child's Age
Child's Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Clothing Size (Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Toddler, Youth or Adult Size)
3-4 Gift Requests or Hobbies (NO BIKES, GIFT CARDS or ELECTRONICS)
Reminder: if you plan on signing up more than one child, you have to click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!

Child #4 Information
Child's Name

First NameLast Name
Gender
Child's Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child's Age
Clothing Size (Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Children, Youth or Adult Size)
3-4 Gift Requests or Hobbies (NO BIKES, GIFT CARDS or ELECTRONICS)
Reminder: if you plan on signing up more than one child, you have to click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!

Child #5 Information
Child's Name

First NameLast Name
Gender
Child's Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child's Age
Clothing Size (Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Children, Youth or Adult Size)
3-4 Gift Requests or Hobbies (NO BIKES, GIFT CARDS or ELECTRONICS)
Reminder: if you plan on signing up more than one child, you have to click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!

Child #6 Information
Child's Name

First NameLast Name
Gender
Child's Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child's Age
Clothing Size (Specify Toddler, Youth or Adult Size)
Shoe Size (Specify Children, Youth or Adult Size)
3-4 Gift Requests or Hobbies (NO BIKES, GIFT CARDS or ELECTRONICS)
Reminder: if you plan on signing up more than one child, you have to click the NEXT button to fill out another form for each child you wish to sign up.

If you are done, please click the SUBMIT FORM button.

Thank you!
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Check Off Each Box To Confirm You Understand Our Terms and Agreements.