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First & Last Name

Email

Phone

Number of Kids needing Backpacks & Supplies

1

2

3

4+

If your choice was 4+, please indicate how many kids

Please share all kids ages, grades, and interests (video games, princesses, etc.) to make their school supplies more personable

Back-to-School Supply Giveaway Acknowledgment

I understand that completing this registration does not guarantee that my family will receive back-to-school supplies or backpacks. Supplies are available in limited quantities and will be distributed while supplies last. I acknowledge that if supplies are no longer available, my family may not receive them.

I Acknowledge

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