Your name (parent or an adult placing an order, sealed letter from Santa will be in waterproof envelope addresses to the adult) *

First Name

Last Name

Have your child received a letter from our Santa from Palm of Hope before?

Yes

No

Your child's full name *

First Name

Last Name

Your child's gender

Boy

Girl

Your full home address (for mailing purposes)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country