11th ANNUAL GIVING TREE PARTY APPLICATION

MAIL TO:

MASS APPEAL INTERNATIONAL 18 Acorn St. Malden MA 02148 

500 lucky children and their families will attend our 11th Annual Giving Tree Christmas Celebration on LIVE TV. It is free. Please fill out the information below for each child age 0-12, for free gifts and food and return it immediately via mail no later than Dec. 10th. 

Time, Cambridge location, and date of the party will be Confirmed with you shortly via email. SAVE THE DATE: Dec. 18th 2011

Parent/ Guardian Name:_______________________Number___________________________

Address_______________________________________________________

Email_________________________________________________________ 

Child’s Name_____________________________Boy __ or Girl__?  Age___?

 

Interactive Television Waiver

I/we understand that in an interactive television environment, my voice, physical presence, and participation in activities will be transmitted to distance sites. I/we also understand that participation in an interactive television environment will be electronically recorded. I/we hereby agree that my participation in an interactive television activity including but not limited to my voice, physical presence, participation and the recording thereof will not be a violation of my personal rights and hereby release any claims for the use of such without further consideration.

Students Name: ____________________________________________

Signature _________________________________________________

Address __________________________ City ____________________

State ____________________________ Zip Code ________________

Date ______/______/______

Parent/Guardian permission required if the subject is a minor

Legal Guardian ____________________________________________

Signature _________________________________________________

Address ___________________________ City ___________________

State ______________________________ Zip Code _______________

Date ______/______/______

 

 

Commenting is closed for this article.