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About Us
News & Events
Project Wee Care
School Support
Scholarships
Annual Golf Scramble
Contact Us
Project Wee Care Submission – Form Test
Project Wee Care Registration
Step
1
of
7
14%
Family Information
Parent/Guardian Name - Nombre del padre o tutor (obligatorio)
(Required)
First/Nombre de pila
Last/Apellido
Parent/Guardian Address - Dirección del padre/madre o tutor (obligatorio)
(Required)
Street Address/dirección postal
Adress Line 2/Línea de dirección 2
City/Ciudad
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State/Estado
Zip Code/Código postal
Email - Correo electrónico (obligatorio)
(Required)
Phone - Teléfono
How would you like to be contacted? - ¿Cómo prefiere ser contactado? (obligatorio)
(Required)
Phone/Teléfono
Email/Correo electrónico
Text/Texto
Ethnicity Requested (please select one) - Origen étnico (por favor, seleccione uno) (obligatorio)
(Required)
American Indian or Alaska Native/Indio Americano o nativo de Alaska
Asian/Asiático
Black or African American/Negro o afroamericano
Hispanic or Latino/Hispano o latino
Native Hawaiian or Other Pacific Islander/Nativo hawaiano u otro isleño del Pacífico
White/Blanco
Do not wish to provide/No deseo proporcionar
What is the primary language in your household? - ¿Cuál es el idioma principal en su hogar? (obligatorio)
(Required)
English/Inglés
Spanish/Español
Tagalog
Arabic/عربي
Vietnamese/Tiếng Việt
Chinese/中国人
Tamil/தமிழ்
Other
Which school nominated you for Project Wee Care by sending you the invite and link to the Family Registration Form? - ¿Cuál es la escuela que nominó a su familia para Project Wee Care por enviándole una invitación y el link de este formulario de registro?(obligatorio)
(Required)
Abbott Elementary
Ackerman Elementary
Aldrich Elementary
Black Elk Elementary
Bryan Elementary
Cather Elementary
Cody Elementary
Cottonwood Elementary
Disney Elementary
Ezra Elementary
Harvey Oaks Elementary
Hitchcock Elementary
Holling Heights Elementary
Morton Elementary
Montclair Elementary
Neihardt Elementary
Norris Elementary
Reagan Elementary
Reeder Elementary
Rockwell Elementary
Rohwer Elementary
Sandoz Elementary
Upchurch Elementary
Wheeler Elementary
Willowdale Elementary
Andersen Middle School
Beadle Middle School
Central Middle School
Kiewit Middle School
North Middle School
Russell Middle School
Keith Lutz Horizon High School
Millard North High School
Millard South High School
Millard West High School
Who nominated your family for Project Wee Care? - ¿Quien nominó a su familia para Project Wee Care? (obligatorio)
(Required)
How many people in your household? - ¿Cuántas personas hay en su hogar? (obligatorio)
(Required)
Please enter a number greater than or equal to
2
.
Please enter a number greater than or equal to 2. Ingresa un numero mayor o igual que 2
How many children do you have from infant to high school senior that match your school registration? - ¿Cuántos niños tiene? Desde infantes hasta el último año de secundaria, que coincidan con su registro escolar. (obligatorio)
(Required)
Please enter a number from
1
to
6
.
Please enter a number from 1 to 6. Ingresa un numero de 1 a 6.
When you go out for a fun family outing, where do you go and/or what do you do (specific restaurants, activities, outings)? - Cuando usted y su familia van a una salida familiar divertida, ¿A dónde van y qué hacen? (especifique: restaurantes, actividades, paseos, etc.)
When you have an adult night out, where do you go and/or what do you do (specific restaurants, activities, outings)? - Cuando usted y su pareja salen sin los niños, ¿A dónde van y qué hacen? (especifique: restaurantes, actividades, paseos, etc.)
If you have a family pet, tell us what kind of pet you have - Si tienes una mascota familiar, cuéntanos qué tipo de mascota tienes.
Child 1/Niño 1
Name/Nombre (obligatorio)
(Required)
First/Primero
Last/Último
Age as of December 14/Edad al 14 de diciembre (obligatrio)
(Required)
Infant
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
School Attending/Escuela al la que asiste (obligatrio)
(Required)
Abbott Elementary
Ackerman Elementary
Aldrich Elementary
Black Elk Elementary
Bryan Elementary
Cather Elementary
Cody Elementary
Cottonwood Elementary
Disney Elementary
Ezra Elementary
Harvey Oaks Elementary
Hitchcock Elementary
Holling Heights Elementary
Morton Elementary
Montclair Elementary
Neihardt Elementary
Norris Elementary
Reagan Elementary
Reeder Elementary
Rockwell Elementary
Rohwer Elementary
Sandoz Elementary
Upchurch Elementary
Wheeler Elementary
Willowdale Elementary
Andersen Middle School
Beadle Middle School
Central Middle School
Kiewit Middle School
Millard North Middle School
Russell Middle School
Keith Lutz Horizon High School
Millard North High School
Millard South High School
Millard West High School
N/A
Other
Current Grade/Grado actual: (obligatorio)
(Required)
Kindergarten
First/Primero
Second/Segundo
Third/Tercero
Fourth/Cuatro
Fifth/Quinto
Sixth/Sexto
Seventh/Séptimo
Eighth/Octavo
Ninth/Noveno
Tenth/Décimo
Eleventh/Undécimo
Twelfth/Duodécimo
Not in School/No en la escuela
Gender/Género (obligatorio)
(Required)
Male/Masculino
Female/Femenino
Other/Prefer Not to Answer/Otro / Prefiero no responder
What needs does this child have? Please provide specific sizes for clothing, shoes, jacket, coats, etc. (girls, boys, adult, youth, etc.) - ¿Cuáles son las necesidades de este niño/niña? Por favor, proporcione tallas específicas para ropa, zapatos, chaqueta/chamarra, abrigos, etc. (niño, niña, adulto, joven, etc.) (obligatorio)
(Required)
Limit to 150 characters
Please provide sizes/ Por favor proporcione tamaños (obligatorio)
(Required)
Please provide favorite colors - Por favor, proporcione los colores favoritos (obligatorio)
(Required)
Please limit to 50 characters
What fun gifts would this child enjoy? - ¿Qué regalos divertidos disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters
What interests, hobbies and activities does this child enjoy? - ¿Qué actividades o pasatiempos le interesan y disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters
Child 2/Niño 2
Name/Nombre (obligatorio)
(Required)
First/Primero
Last/Último
Age as of December 14/Edad al 14 de diciembre (obligatrio)
(Required)
Infant
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
School Attending/Escuela al la que asiste (obligatrio)
(Required)
Abbott Elementary
Ackerman Elementary
Aldrich Elementary
Black Elk Elementary
Bryan Elementary
Cather Elementary
Cody Elementary
Cottonwood Elementary
Disney Elementary
Ezra Elementary
Harvey Oaks Elementary
Hitchcock Elementary
Holling Heights Elementary
Morton Elementary
Montclair Elementary
Neihardt Elementary
Norris Elementary
Reagan Elementary
Reeder Elementary
Rockwell Elementary
Rohwer Elementary
Sandoz Elementary
Upchurch Elementary
Wheeler Elementary
Willowdale Elementary
Andersen Middle School
Beadle Middle School
Central Middle School
Kiewit Middle School
Millard North Middle School
Russell Middle School
Keith Lutz Horizon High School
Millard North High School
Millard South High School
Millard West High School
N/A
Other
Current Grade/Grado actual: (obligatorio)
(Required)
Kindergarten
First/Primero
Second/Segundo
Third/Tercero
Fourth/Cuatro
Fifth/Quinto
Sixth/Sexto
Seventh/Séptimo
Eighth/Octavo
Ninth/Noveno
Tenth/Décimo
Eleventh/Undécimo
Twelfth/Duodécimo
Not in School/No en la escuela
Gender/Género (obligatorio)
(Required)
Male/Masculino
Female/Femenino
Other/Prefer Not to Answer/Otro / Prefiero no responder
What needs does this child have? Please provide specific sizes for clothing, shoes, jacket, coats, etc. (girls, boys, adult, youth, etc.) - ¿Cuáles son las necesidades de este niño/niña? Por favor, proporcione tallas específicas para ropa, zapatos, chaqueta/chamarra, abrigos, etc. (niño, niña, adulto, joven, etc.) (obligatorio)
(Required)
Examples: clothing, coats, boots, athletic apparel/ Ejemplos: ropa, abrigos, botas, ropa deportiva.
Please provide sizes/ Por favor proporcione tamaños (obligatorio)
(Required)
Please provide favorite colors - Por favor, proporcione los colores favoritos (obligatorio)
(Required)
What fun gifts would this child enjoy? - ¿Qué regalos divertidos disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters/ Por favor limite a 150 caracteres
What interests, hobbies and activities does this child enjoy? - ¿Qué actividades o pasatiempos le interesan y disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters/ Por favor limite a 150 caracteres
Child 3/ Niño 3
Name/Nombre (obligatorio)
(Required)
First/Primero
Last/Último
Age as of December 14/Edad al 14 de diciembre (obligatrio)
(Required)
Infant
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
School Attending/Escuela al la que asiste (obligatrio)
(Required)
Abbott Elementary
Ackerman Elementary
Aldrich Elementary
Black Elk Elementary
Bryan Elementary
Cather Elementary
Cody Elementary
Cottonwood Elementary
Disney Elementary
Ezra Elementary
Harvey Oaks Elementary
Hitchcock Elementary
Holling Heights Elementary
Morton Elementary
Montclair Elementary
Neihardt Elementary
Norris Elementary
Reagan Elementary
Reeder Elementary
Rockwell Elementary
Rohwer Elementary
Sandoz Elementary
Upchurch Elementary
Wheeler Elementary
Willowdale Elementary
Andersen Middle School
Beadle Middle School
Central Middle School
Kiewit Middle School
Millard North Middle School
Russell Middle School
Keith Lutz Horizon High School
Millard North High School
Millard South High School
Millard West High School
N/A
Other
Current Grade/Grado actual: (obligatorio)
(Required)
Kindergarten
First/Primero
Second/Segundo
Third/Tercero
Fourth/Cuatro
Fifth/Quinto
Sixth/Sexto
Seventh/Séptimo
Eighth/Octavo
Ninth/Noveno
Tenth/Décimo
Eleventh/Undécimo
Twelfth/Duodécimo
Not in School/No en la escuela
Gender/Género (obligatorio)
(Required)
Male/Masculino
Female/Femenino
Other/Prefer Not to Answer/Otro / Prefiero no responder
What needs does this child have? Please provide specific sizes for clothing, shoes, jacket, coats, etc. (girls, boys, adult, youth, etc.) - ¿Cuáles son las necesidades de este niño/niña? Por favor, proporcione tallas específicas para ropa, zapatos, chaqueta/chamarra, abrigos, etc. (niño, niña, adulto, joven, etc.) (obligatorio)
(Required)
Examples: clothing, coats, boots, athletic apparel/ Ejemplos: ropa, abrigos, botas, ropa deportiva.
Please provide sizes/ Por favor proporcione tamaños (obligatorio)
(Required)
Please provide favorite colors - Por favor, proporcione los colores favoritos (obligatorio)
(Required)
What fun gifts would this child enjoy? - ¿Qué regalos divertidos disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters/ Por favor limite a 150 caracteres
What interests, hobbies and activities does this child enjoy? - ¿Qué actividades o pasatiempos le interesan y disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters/ Por favor limite a 150 caracteres
Child 4/Niño 4
Name/Nombre (obligatorio)
(Required)
First/Primero
Last/Último
Age as of December 14/Edad al 14 de diciembre (obligatrio)
(Required)
Infant
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
School Attending/Escuela al la que asiste (obligatrio)
(Required)
Abbott Elementary
Ackerman Elementary
Aldrich Elementary
Black Elk Elementary
Bryan Elementary
Cather Elementary
Cody Elementary
Cottonwood Elementary
Disney Elementary
Ezra Elementary
Harvey Oaks Elementary
Hitchcock Elementary
Holling Heights Elementary
Morton Elementary
Montclair Elementary
Neihardt Elementary
Norris Elementary
Reagan Elementary
Reeder Elementary
Rockwell Elementary
Rohwer Elementary
Sandoz Elementary
Upchurch Elementary
Wheeler Elementary
Willowdale Elementary
Andersen Middle School
Beadle Middle School
Central Middle School
Kiewit Middle School
Millard North Middle School
Russell Middle School
Keith Lutz Horizon High School
Millard North High School
Millard South High School
Millard West High School
N/A
Other
Current Grade/Grado actual: (obligatorio)
(Required)
Kindergarten
First/Primero
Second/Segundo
Third/Tercero
Fourth/Cuatro
Fifth/Quinto
Sixth/Sexto
Seventh/Séptimo
Eighth/Octavo
Ninth/Noveno
Tenth/Décimo
Eleventh/Undécimo
Twelfth/Duodécimo
Not in School/No en la escuela
Gender/Género (obligatorio)
(Required)
Male/Masculino
Female/Femenino
Other/Prefer Not to Answer/Otro / Prefiero no responder
What needs does this child have? Please provide specific sizes for clothing, shoes, jacket, coats, etc. (girls, boys, adult, youth, etc.) - ¿Cuáles son las necesidades de este niño/niña? Por favor, proporcione tallas específicas para ropa, zapatos, chaqueta/chamarra, abrigos, etc. (niño, niña, adulto, joven, etc.) (obligatorio)
(Required)
Examples: clothing, coats, boots, athletic apparel/ Ejemplos: ropa, abrigos, botas, ropa deportiva.
Please provide sizes/ Por favor proporcione tamaños (obligatorio)
(Required)
Please provide favorite colors - Por favor, proporcione los colores favoritos (obligatorio)
(Required)
What fun gifts would this child enjoy? - ¿Qué regalos divertidos disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters/ Por favor limite a 150 caracteres
What interests, hobbies and activities does this child enjoy? - ¿Qué actividades o pasatiempos le interesan y disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters/ Por favor limite a 150 caracteres
Child 5/Niño 5
Name/Nombre (obligatorio)
(Required)
First/Primero
Last/Último
Age as of December 14/Edad al 14 de diciembre (obligatrio)
(Required)
Infant
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
School Attending/Escuela al la que asiste (obligatrio)
(Required)
Abbott Elementary
Ackerman Elementary
Aldrich Elementary
Black Elk Elementary
Bryan Elementary
Cather Elementary
Cody Elementary
Cottonwood Elementary
Disney Elementary
Ezra Elementary
Harvey Oaks Elementary
Hitchcock Elementary
Holling Heights Elementary
Morton Elementary
Montclair Elementary
Neihardt Elementary
Norris Elementary
Reagan Elementary
Reeder Elementary
Rockwell Elementary
Rohwer Elementary
Sandoz Elementary
Upchurch Elementary
Wheeler Elementary
Willowdale Elementary
Andersen Middle School
Beadle Middle School
Central Middle School
Kiewit Middle School
Millard North Middle School
Russell Middle School
Keith Lutz Horizon High School
Millard North High School
Millard South High School
Millard West High School
N/A
Other
Current Grade/Grado actual: (obligatorio)
(Required)
Kindergarten
First/Primero
Second/Segundo
Third/Tercero
Fourth/Cuatro
Fifth/Quinto
Sixth/Sexto
Seventh/Séptimo
Eighth/Octavo
Ninth/Noveno
Tenth/Décimo
Eleventh/Undécimo
Twelfth/Duodécimo
Not in School/No en la escuela
Gender/Género (obligatorio)
(Required)
Male/Masculino
Female/Femenino
Other/Prefer Not to Answer/Otro / Prefiero no responder
What needs does this child have? Please provide specific sizes for clothing, shoes, jacket, coats, etc. (girls, boys, adult, youth, etc.) - ¿Cuáles son las necesidades de este niño/niña? Por favor, proporcione tallas específicas para ropa, zapatos, chaqueta/chamarra, abrigos, etc. (niño, niña, adulto, joven, etc.) (obligatorio)
(Required)
Examples: clothing, coats, boots, athletic apparel/ Ejemplos: ropa, abrigos, botas, ropa deportiva.
Please provide sizes/ Por favor proporcione tamaños (obligatorio)
(Required)
Please provide favorite colors - Por favor, proporcione los colores favoritos (obligatorio)
(Required)
What fun gifts would this child enjoy? - ¿Qué regalos divertidos disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters/ Por favor limite a 150 caracteres
What interests, hobbies and activities does this child enjoy? - ¿Qué actividades o pasatiempos le interesan y disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters/ Por favor limite a 150 caracteres
Child 6/Niño 6
Name/Nombre (obligatorio)
(Required)
First/Primero
Last/Último
Age as of December 14/Edad al 14 de diciembre (obligatrio)
(Required)
Infant
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
School Attending/Escuela al la que asiste (obligatrio)
(Required)
Abbott Elementary
Ackerman Elementary
Aldrich Elementary
Black Elk Elementary
Bryan Elementary
Cather Elementary
Cody Elementary
Cottonwood Elementary
Disney Elementary
Ezra Elementary
Harvey Oaks Elementary
Hitchcock Elementary
Holling Heights Elementary
Morton Elementary
Montclair Elementary
Neihardt Elementary
Norris Elementary
Reagan Elementary
Reeder Elementary
Rockwell Elementary
Rohwer Elementary
Sandoz Elementary
Upchurch Elementary
Wheeler Elementary
Willowdale Elementary
Andersen Middle School
Beadle Middle School
Central Middle School
Kiewit Middle School
Millard North Middle School
Russell Middle School
Keith Lutz Horizon High School
Millard North High School
Millard South High School
Millard West High School
N/A
Other
Current Grade/Grado actual: (obligatorio)
(Required)
Kindergarten
First/Primero
Second/Segundo
Third/Tercero
Fourth/Cuatro
Fifth/Quinto
Sixth/Sexto
Seventh/Séptimo
Eighth/Octavo
Ninth/Noveno
Tenth/Décimo
Eleventh/Undécimo
Twelfth/Duodécimo
Not in School/No en la escuela
Gender/Género (obligatorio)
(Required)
Male/Masculino
Female/Femenino
Other/Prefer Not to Answer/Otro / Prefiero no responder
What needs does this child have? Please provide specific sizes for clothing, shoes, jacket, coats, etc. (girls, boys, adult, youth, etc.) - ¿Cuáles son las necesidades de este niño/niña? Por favor, proporcione tallas específicas para ropa, zapatos, chaqueta/chamarra, abrigos, etc. (niño, niña, adulto, joven, etc.) (obligatorio)
(Required)
Examples: clothing, coats, boots, athletic apparel/ Ejemplos: ropa, abrigos, botas, ropa deportiva.
Please provide sizes/ Por favor proporcione tamaños (obligatorio)
(Required)
Please provide favorite colors - Por favor, proporcione los colores favoritos (obligatorio)
(Required)
What fun gifts would this child enjoy? - ¿Qué regalos divertidos disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters/ Por favor limite a 150 caracteres
What interests, hobbies and activities does this child enjoy? - ¿Qué actividades o pasatiempos le interesan y disfruta este niño o niña? (obligatorio)
(Required)
Please limit to 150 characters/ Por favor limite a 150 caracteres
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