2026 ESLAC Breakfast with Santa Registration

ESLAC Annual Breakfast with Santa Registration Form- PLEASE READ ENTIRE FORM CAREFULLY

An email is required to receive Big Toy winner confirmation. Winners must pick up gifts on the day of the event, December 5, 2026 at Mason Clark Middle School. Please be certain to type your email correctly. Remember if your child is not a winner, every child in attendance on December 5th will receive a Free Toy, Free Breakfast, Free Picture with Santa and can participate in Free Fun Activities!

Email

example@example.com

Name (Adult Only)

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Please select which category you would like to enter in. If you have more than one child in a category, you will have to submit another form at the end.

How many individual children are you registering?

Group Entry List

Only 1 link will be sent to the email address above. You will be responsible for picking up all items in one visit. Thank You!

Sponsor or Point of Contact Name

First NameLast Name

Address of Group

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone number

Please enter a valid phone number.Format: (000) 000-0000.

How many in the group?

Please upload an Excel Sheet of each child's 1st name, last name, age, and gender

Category of Child 1

Name of Child 1

First NameLast Name

Age of Child 1

Category of Child 2

Name of Child 2

First NameLast Name

Age of Child 2

Category of Child 3

Name of Child 3

First NameLast Name

Age of Child 3

Category of Child 4

Name of Child 4

First NameLast Name

Age of Child 4

Category of Child 5

Name of Child 5

First NameLast Name

Age of Child 5

Category of Child 6

Name of Child 6

First NameLast Name

Age of Child 6

Category of Child 7

Name of Child 7

First NameLast Name

Age of Child 7

Category of Child 8

Name of Child 8

First NameLast Name

Age of Child 8

Category of Child 9

Name of Child 9

First NameLast Name

Age of Child 9

Category of Child 10

Name of Child 10

First NameLast Name

Age of Child 10

Photo, Media and Video Authorization Release Form

Please check all boxes below.

Photo, Media and Video Authorization Release Form

I/We understand and agree that these Images will become the property of the Chapter, which shall have complete ownership of the Images. I hereby irrevocably authorized the Chapter to publish or distribute these Images for the purpose of publicizing the Chapter’s programs, including the Breakfast with Santa Initiative Program or for any other lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my child’s likeness appears. Additionally, I waive any rights to royalties or other compensation arising out of or related to the use of the Images.I/We hereby hold harmless and release and forever discharge the Chapter and any of its officers and members; Delta Sigma Theta Sorority, Incorporated; its officers; National Executive Board; employees; members; representatives; agents; and assigns from any and all claims, costs, suits, actions, judgments, and expenses which my child, his/her heirs, representatives, executors, administrators, or any other persons acting on his/her behalf have or may have by reason of the use of the Images. This release specifically includes, without limitation, a complete release and discharge of any liability by virtue of any editing, distortion, alteration, or optical illusion, whether intentional or otherwise, that may occur or be produced in the taking of or editing of said Images, unless it can be shown that such was maliciously caused, produced and published solely for the purpose of subjecting my child to conspicuous ridicule, scandal, reproach, scorn and indignity.