Online Forms

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5. Bucket Fillers Registration Form
   Are you running out of creative activities for your kids? Sign up for FREE crafts and parenting materials delivered to your door or available for pick up! Bucket Fillers offers developmentally-appropriate crafts for your 7-12 year-olds.
7. NOTE: PLEASE COMPLETE A SEPARATE FORM FOR EACH CHILD
   If you would like to register multiple children for a craft delivery, please complete a separate form for each child.
9. Details
   Date & Time: drop off will take place on January 19
   Location: Home delivery or pick up at West Fraser Guild (821 Switzer Drive) from 8:00-4:00pm
11. Caregiver's First Name*
12. Caregiver's Last Name
14. Child's Name
15. Child's Age*
    -- Select One --789101112

    Please select the age of your child
17. Email Address*
18. Phone Number*
20. Home Address *
    This is where packages will be delivered or if you prefer to pick up package type pick up. Pick up will be available from 8:00-4:00pm on January 19
22. Additional Delivery Instructions
24. Would you like to learn more about additional parent education and support services? *

    1. Yes
    2. No

    Your contact information will be used by the Caregiver Education Coordinator to contact you or share information with you
26. Additional Comments
    (please add any additional feedback here)
28. Thank You!
    PLEASE NOTE: deliveries will be made on January 19. Packages will be dropped off on front porch; please check your front porch for delivery.
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field