Fill Out the Form Below to Apply – Blankets of Blessing

SATURDAY, DECEMBER 2, 2023

MIKE FRETZ EVENT CENTER

11545 E 43^RD ST

TULSA, OK 74146

11:00-2:30 PM

Dear Parent/Guardian,

We would like to invite you and your child/children to participate in Blankets of Blessing. The goal of Blankets of Blessing is to provide children between the ages 0-7 with his or her very own blanket and other gifts as an expression of the importance, value, and worth of their individual lives. If you are interested in applying to receive a blanket and other items for your child(ren) from Blankets of Blessing, please complete the application below and return by NO LATER THAN FRIDAY, OCTOBER 1, 2023.

NOTE: ALL FAMILY MEMBERS ATTENDING THE EVENT MUST BE LISTED ON THE APPLICATION & RELATIONSHIP TO CHILD STATED

(ie-grandmother, etc) We are limited on number attending so child’s parents & siblings are first priority on approval to attend.

Name of Parent(s)/Guardian(s) *

Full Address *

Address, City State, Zip Code

Cell Phone Number *

Email *

Child 1 (Required) *

Example: Tim, 3, M, Small

Child 2 (If Applicable)

Example: Tim, 3, M, Small

Child 3 (If Applicable)

Example: Tim, 3, M, Small

Child 4 (If Applicable)

Example: Tim, 3, M, Small

Additional Family Member(s) and Relationship to Child Attending

For any older kids attending, please list child's age and gender.

Please Check Applicable Items *

My child(ren) attends Head Start, C.A.R.D. or CAP Tulsa
Assistance received from Supplemental Nutrition Assistance Program (SNAP)
Assistance received from Sooner Care
Assistance received from Special Supplemental Nutrition Program for Women, Infants, & Children (WIC)

How Did You Hear About Us? *

Photo release: By my participation and my child(ren)’s in Blankets of Blessing, I am willfully giving Blankets of Blessing Inc. permission and the right to reproduce in any of its printed and online publications all photos is has produced of myself and my child(ren) attending the event. *

Please enter your name to agree to the photo release. This will serve as the Parent/Guardian's Electronic Signature.