Power of Deliverance International Church - "For Our God Is A Consuming Fire"  Hebrews 12:29
               2018 Registration Form for Toys for Tots                                              Deadline  to submit form: December 10th at 12 pm.                                                   Note: It is important that you provide your phone number and email address.  You will be contacted by phone or email regarding the date and time to pick up toys.  Photo ID and Children Birth Certificate are required at the time of pick-up.                                                                        
Please complete form below
Date
Name
Address
City
Zip
Phone
Email
Number of Family Members in Household
Name of Child
Age
Select the age group of your child below
0-24 month Boy
3-5 yr. Boy
6-7 yr. Boy
8-10 yr. Boy
11-12 yr. Boy
0-24 month Girl
3-5 yr. Girl
6-7 yr. Girl
8-10 yr. Girl
11-12 yr. Girl
Additional Comments




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