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We Can Kids Program
Please enter the information below to be a part of our organization.
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This information is kept private, and this information is not shared outside of our organization team unless given permission by parent. This form is intended for those 21 & under.
I understand
"We Can Kid" Name
*
Your answer
Birthday
*
Your answer
Age
*
Your answer
Disability
*
Your answer
Parent email
*
Your answer
Parent phone number
*
Your answer
Tell us about your We Can Kid! (Very Important to us!)
Your answer
Address (if you would like items sent out to you!)
Your answer
Please list their interests, or gifts they like!
*
Your answer
Are there any important dates we should know of? (important milestones, surgery anniversaries, upcoming surgery dates, etc)
Your answer
Something your We Can Kid is proud of / has accomplished
Your answer
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