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Community Christmas Dinner Registration Form

Please complete one per family. Please note that we might not be able to accommodate all needs, allergies, preferences, etc. however we will do our best!

Name *
Name
Phone
Phone
Are you registering yourself/your family, or is this a third party registration *
If you are a community or partner organization registering on behalf of someone else please provide your name, organization (e.g. Shumilacke Food Bank, VON, etc.) and contact information in the Comments field below.
If more than one attending please provide their names and ages below
Are you interested in helping out?
If you are interested in volunteering, donating or in any other way helping us out please let us know below and we will contact you for more information. Please select any/all that apply!
Please let us know if you have any allergies or dietary restrictions or any accessibility issues we should be aware of. If you are completing this registration on behalf of someone please provide your name, organization and contact information here as well as any other information we might need.