Register A Kid

Please fill out all the required fields!

• Name of parent who serves in the military*

  Prefix

  First Name

  Middle Name

  Last Name
• Email Address*

  eg. johndoe@mail.com
• Address*

  Address Line 1
  Address Line 2
  City	State
  Zip Code	Country
• Child's Name*

  Prefix

  First Name

  Middle Name

  Last Name
• Grade Level*

  Preschool and Infant are also acceptable if the child is not of school age yet.
• Child's BirthDate*
• Hospital or VA currently assigned to*
• Reason for Hospitalization*
• Branch of Service*

  For Reservist or National Guard please select the main branch association.

  Army Navy Marine Corp Air Force Coast Guard
• Pay Grade*
• Years of Service/Number of Deployments*
• Estimated length of hospitalization*
• Favorites:*

  Please tell us your child's things. Ex: color, food, books, characters, music, sports teams.
• Hobbies and Special Interests:*
• I'm interested in signing up for*

  Sponsorship

  Pen-Pal Program

  Financial Assistance
• I would like to register 1 or more additional siblings*

  If 'yes' we will be contacting you via email to get each child's personal info. You do not have to re-do this form over again.

  Yes.

  No.
• Security Code*
  

   

• Please fill out all the required fields!
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