Secret Santa Request Form 2026

Secret Santa Request Form (2026)

Please complete the entire form and submit it between NOVEMBER 2-23,2026.

Children under the age of 12 years are eligible to participate.

INCOMPLETE FORMS AND FORMS RECEIVED AFTER NOVEMBER 23rd, 2026, WILL NOT BE ACCEPTED

Members of UTBC and the community in need, and families who have experienced Job Loss. Incomplete forms and forms received after the deadline will not be accepted.

IF APPLICATION IS ACCEPTED, GIFTS WILL BE DISTRIBUTED AT UGLY PAJAMAS BREAKFAST WITH SANTA & FRIENDS ON SAT. DEC 19TH 9:00 AM
2026 Secret Santa: Request Form and Wish List Union Temple Baptist Church (UTBC) Family #:
Todays Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Your Name
Your Email Address
example@example.com
Your Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Please type the name of the Family nominated for the Secret Santa opportunity
Please Briefly describe the family being nominated for the Secret Santa opportunity and the current challenges faced?
Please choose the category that best applies (you may select more than one if applicable):
Family Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number
Cell Phone Number
Work Phone Number
NUMBER OF FAMILY MEMBERS
Number of Adults
Number of Children (PLEASE COMPLETE WISH LIST ON NEXT PAGE)
Childs #1 Name
Sex
Age
Childs #2 Name
Sex
Age
Childs #3 Name
Sex
Age
Childs #4 Name
Sex
Age
CHILD #5 Name
Sex
Age
Child #6 Name
Sex
Age
Child #7 Name
Sex
Age
Please Note: The families selected to receive a Secret Santa will be contacted directly by a member of the UTBC Christmas ministry. Due to an increased need for outreach and support during this season, we cannot guarantee that all families will be selected. We will try to help as many families as possible.

Page 1 of 2 The information on this form will be kept confidential.

2026 Secret Santa: Request Form and Wish List Union Temple Baptist Church (UTBC) Please use this space below to list some items your children would like to receive from their Secret Santa

Family #:
Family
Secret Santa Wish List (2026)

Instructions: Please use the space below to list some items your child(ren) would like to receive from their Secret Santa.
Please list some items your child(ren) would like to receive from their Secret Santa (Child #, Sex, Age, Wish List: EXAMPLE - Child #1, Boy, 5, Bat man car, baseballs)
Please list some items your child(ren) would like to receive from their Secret Santa (Gender, Age, Wish List)
Should be Empty: