Family Registration

Until the Event

Days

Hours

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Step 1 of 250%

👨‍👩‍👧‍👦 Parent/Guardian Information

First Name *

Last Name *

Phone Number *

10 digits only, no spaces or dashes

Email Address *

Preferred Contact Method *

ZIP Code *

County *

How many adults live in your household? *

Approximate annual household income before taxes (Optional)

Used only for aggregate statistics and grant reporting. This does not affect eligibility.

Which assistance programs does your household currently receive? *

Choose all that apply.

CalFresh / SNAP / EBTCalWORKs / TANF / Cash AidWICMedi-CalSSI (Supplemental Security Income)CMSP (County Medical Services Program)General Assistance / General ReliefSection 8 / Housing Choice VoucherPublic / Subsidized HousingSNCS — Sierra Nevada Children’s Services / Child Care AssistanceHead Start / Early Head Start — KidZCommunityIncome-qualified for Free/Reduced-Price Meals (FRPM)Foster Care / Kinship Care AssistanceIHSS (In-Home Supportive Services)Project GO / HEAP Energy AssistancePG&E CARE / FERA Utility DiscountCalifornia LifeLineTribal TANF / Tribal AssistanceFood Bank / Food Pantry AssistanceVeterans BenefitsUnemployment BenefitsOtherPrefer not to sayNone

How many children age 18 or younger live in the home? *

🧸 Children's Information

Please provide information for each of your 1 child.

Child 1 - Age *

Sex *

🍗 Holiday Meal Assistance

We offer a complete holiday meal package for families who need it. This includes a protein of your choice (Turkey, Ham, or Chicken) along with all the fixings for a warm holiday dinner.

No, we do not need food assistance

We're here for toys only

Yes, we would like food assistance

We'd appreciate a holiday meal for our family

Additional Notes (Optional)

Dietary restrictions, special needs, or other comments