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Jolly 'Ole Santa Haulers Christmas Assistance

  1. Complete One Form For Each Child

  2. Girl

  3. Boy

  4. NO ELECTRONICS!

    No electronics such as D.S., gaming consoles, cellphones, etc.

  5. If you have a special needs child, please indicate any special needs requirements or requests.

  6. Leave This Blank:

  7. This field is not part of the form submission.